Thomas W Bieber, DDS
Individual provider Active NPI General Practice Dentistry · Clear Lake, IA
NPI 1356420137 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1356420137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 7229 (IA)
- Practice address
- 102 N 5TH St
Clear Lake, IA 50428-1803 - Phone
- (641) 357-4112
- Fax
- (641) 357-0670
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150309001261 | IA | Order and Referring Only - Oral Surgery |
9133445232 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7229 | IA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Dental Associates PC | General Practice | Past | Accepting new patients |
| Bieber Dental PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7229 | IA | Yes |
Addresses
Primary practice location
102 N 5TH St
Clear Lake, IA 50428-1803
Mailing address
102 N 5TH St
Clear Lake, IA 50428-1803
Phone (641) 357-4112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0248443 | Medicaid | IA |
Other providers in Clear Lake, IA
- Donald C Berge
- Sydney Rae Bermel
- Bieber Dental PLLC
- Elizabeth Bieber
- Matthew Bieber
- Taylor Ann Blickenderfer
- Sheila Boekelman-Gelhaus
- Margaret Bowen
- John Brady
- McKenzie Brekken
All providers in Clear Lake, IA · General Practice Dentistry in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.