Individual provider Active NPI

Sean D McGivern, DDS

  • Pediatric Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1316476922
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DDS-09422 Issued in IA
Practice address
5350 Kirkwood Blvd SW Ste 700
Cedar Rapids, IA 52404-5234
Phone
(319) 481-4281
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS-09422 IA
Pediatric Dentistry 1223P0221X 106934 CA
Pediatric Dentistry 1223P0221X DDS-09422 IA Primary

Addresses

Primary practice location

5350 Kirkwood Blvd SW Ste 700
Cedar Rapids, IA 52404-5234

Mailing address

5350 Kirkwood Blvd SW Ste 700
Cedar Rapids, IA 52404-5234
Phone (319) 481-4281

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
DDS-09422IAMDGeneral Practice Dentistry
106934CAMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: smcgivern42388@altamed.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1316476922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 KIRKWOOD BLVD SW STE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524045234",
            "telephone_number": "319-481-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 KIRKWOOD BLVD SW STE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524045234",
            "telephone_number": "319-481-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGIVERN",
        "first_name": "SEAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09422",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "106934",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "DDS-09422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.