Individual provider Active NPI

Robert Scott Daniels, D.D.S.

  • General Practice Dentistry
  • Eldridge, IA
National Provider Identifier
1356365381
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7239 Issued in IA
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, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
27334OtherIAWELLMARK BC/BS
0056085MedicaidIA
469781OtherIAUNITED 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

LicenseStateTypeSpecialty
7239IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eldridge Family Dentistry LLC General Practice PastSince Nov 6, 2022 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.

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.

Verify at the official NPI Registry.