Iowa Pediatric Dental Center II LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

08193 Issued in IA

Legal business name

IOWA PEDIATRIC DENTAL CENTER II LLC

Practice address

5350 Kirkwood Blvd SW
Suite 700
Cedar Rapids, IA 52404-5233

Phone

(319) 366-0600

Fax

(319) 366-1316

NPI assigned

Mar 6, 2014

Organization subpart

Yes

Parent organization

IOWA PEDIATRIC DENTAL CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Donald Craig Peterson Jr., D.D.S.

Title

Doctor/Owner

Phone

(319) 366-0600

Specialties & licenses 1

Addresses

Part of

Iowa Pediatric Dental Center

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Iowa Pediatric Dental Center

  • Pediatric Dentistry
  • Coralville, IA
  • NPI 1639595952
  NPPES parent name

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1245656800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 KIRKWOOD BLVD SW",
            "address_2": "SUITE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524045233",
            "telephone_number": "319-366-0600",
            "fax_number": "319-366-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 KIRKWOOD BLVD SW",
            "address_2": "SUITE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524045233",
            "telephone_number": "319-366-0600",
            "fax_number": "319-366-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PEDIATRIC DENTAL CENTER II LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA PEDIATRIC DENTAL CENTER",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "319-366-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "08193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Iowa Physical Therapy PC
• Iowa Physical Therapy, P.C.
• Iowa Physicians Clinic Medical Foundation
• Iowa Physicians Clinic Medical Foundation
• Iowa Physicians Clinic Medical Foundation

• Pediatric Dentistry in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Pediatric Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.