NPIMap

Organization Active NPI

Iowa Dental Group LLC

Doing business as Iowa Dental Group

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1265204234
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
IOWA DENTAL GROUP LLC
Doing business as
Iowa Dental Group
Practice address
1233 63Rd St
Des Moines, IA 50311-1943
Phone
(515) 277-6358
NPI assigned
Oct 24, 2023
Last updated
Oct 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
VIDENTA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Mr. Lucas Bland
Title
Coo
Phone
(515) 577-6367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

1233 63Rd St
Des Moines, IA 50311-1943

Mailing address

1233 63Rd St
Des Moines, IA 50311-1943
Phone (515) 277-6358

Other names 1

  • Iowa Dental Group Doing business as

National Provider Directory

National Provider Directory
Part of
Videnta LLC

Locations

1233 63rd St
Des Moines, IA 50311
Phone (515) 277-6358

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1265204234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 63RD ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503111943",
            "telephone_number": "515-277-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 63RD ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503111943",
            "telephone_number": "515-277-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA DENTAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIDENTA, LLC",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "BLAND",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-577-6367",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iowa Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.