NPIMap

Organization Active NPI

Fort Des Moines Dental

  • Dentist
  • Des Moines, IA
National Provider Identifier
1285995530
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6030 Issued in IA
Legal business name
FORT DES MOINES DENTAL
Practice address
6100 SW 9TH St
Des Moines, IA 50315-5013
Phone
(515) 287-5400
Fax
(515) 287-5401
NPI assigned
Jun 4, 2012
Last updated
Jun 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Mark LazarNPI 1558383075
Title
Owner
Phone
(515) 287-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6030 IA Primary

Addresses

Primary practice location

6100 SW 9TH St
Des Moines, IA 50315-5013

Mailing address

6100 SW 9TH St
Des Moines, IA 50315-5013

National Provider Directory

National Provider Directory

Locations

6100 SW 9th St
Des Moines, IA 50315
Phone (515) 287-5400

Practitioners & affiliated clinicians

Practitioners 6

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": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1285995530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503155013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 SW 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503155013",
            "telephone_number": "515-287-5400",
            "fax_number": "515-287-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT DES MOINES DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "LAZAR",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-287-5400"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "6030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 4, 2012; 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.