NPIMap

Individual provider Active NPI

Michael Theodore Lindeberg I, DDS

  • Dentist
  • Indianola, IA
National Provider Identifier
1225129455
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08581 Issued in IA
Practice address
212 N Buxton St
Indianola, IA 50125-2431
Phone
(515) 961-0534
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D8745 OR
Dentist 122300000X 08581 IA Primary

Addresses

Primary practice location

212 N Buxton St
Indianola, IA 50125-2431

Mailing address

212 N Buxton St
Indianola, IA 50125-2431
Phone (515) 961-0534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08581IAMDDentist
D8745ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Indianola Family Dentistry PLC Past Accepting new patients
Indianola Dental Associates Inc PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1225129455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N BUXTON ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252431",
            "telephone_number": "515-961-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N BUXTON ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252431",
            "telephone_number": "515-961-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDEBERG",
        "first_name": "MICHAEL",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8745",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.