Active NPI
Robert Scott Daniels, D.D.S.
- General Practice Dentistry
- Eldridge, IA
National Provider Identifier
1356365381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7239
- Practice address
- 201 N 6TH Ave
Eldridge, IA 52748-1759 - Phone
- (563) 285-8662
- Fax
- (563) 285-1337
- NPI assigned
- Jul 26, 2006
- Last updated
- May 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7239 | IA | Primary |
Addresses
Primary practice location
201 N 6TH Ave
Eldridge, IA 52748-1759
Mailing address
201 N 6TH Ave
Eldridge, IA 52748-1759
Phone (563) 285-8662
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27334 | Other | IA | WELLMARK BC/BS |
| 0056085 | Medicaid | IA | |
| 469781 | Other | IA | UNITED CONCORDIA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7239 | IA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eldridge Family Dentistry LLC | General Practice | Past | Accepting new patients |
| Eldridge Family Dentistry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Eldridge, IA
- NPI 1417664913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1356365381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 N 6TH AVE",
"city": "ELDRIDGE",
"state": "IA",
"postal_code": "527481759",
"telephone_number": "563-285-8662",
"fax_number": "563-285-1337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N 6TH AVE",
"city": "ELDRIDGE",
"state": "IA",
"postal_code": "527481759",
"telephone_number": "563-285-8662",
"fax_number": "563-285-1337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "ROBERT",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "7239",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC/BS",
"identifier": "27334",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0056085",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "469781",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eldridge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.