NPIMap

Organization Active NPI

Pediatric Dentistry of Central Iowa, P.C.

Doing business as Pediatric Dentistry

  • Pediatric Dentistry
  • Des Moines, IA
National Provider Identifier
1275618886
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTISTRY OF CENTRAL IOWA, P.C.
Doing business as
Pediatric Dentistry
Practice address
1000 73Rd St
Suite 10
Des Moines, IA 50324-1321
Phone
(515) 223-1298
Fax
(515) 223-1959
NPI assigned
Oct 25, 2006
Last updated
Jul 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Dr. Vincent W. Mancuso Jr., D.D.S.NPI 1790746048
Title
President
Phone
(515) 223-1298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X IA Primary

Addresses

Primary practice location

1000 73Rd St
Suite 10
Des Moines, IA 50324-1321

Mailing address

1000 73Rd St
Suite 10
Des Moines, IA 50324-1321
Phone (515) 223-1298

Other names 1

  • Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1275618886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 73RD ST",
            "address_2": "SUITE 10",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503241321",
            "telephone_number": "515-223-1298",
            "fax_number": "515-223-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 73RD ST",
            "address_2": "SUITE 10",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503241321",
            "telephone_number": "515-223-1298",
            "fax_number": "515-223-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF CENTRAL IOWA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-223-1298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry",
            "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 Jul 12, 2010; 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.