Organization Active NPI

David C Wertz DDS Ms PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dubuque, IA
National Provider Identifier
1366586455
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5979 Issued in IA
Legal business name
DAVID C WERTZ DDS MS PC
Practice address
2615 Dodge St
Dubuque, IA 52003-7123
Phone
(563) 556-3555
Fax
(563) 556-8379
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Charles Wertz, DDS
Title
President
Phone
(563) 556-3555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 5979 IA Primary

Addresses

Primary practice location

2615 Dodge St
Dubuque, IA 52003-7123

Mailing address

2615 Dodge St
Dubuque, IA 52003-7123
Phone (563) 556-3555

Other identifiers 1

IdentifierTypeStateIssuer
0128256MedicaidIA

National Provider Directory

National Provider Directory

Locations

2615 Dodge St
Dubuque, IA 52003
Phone (563) 556-3555

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366586455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 DODGE ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037123",
            "telephone_number": "563-556-3555",
            "fax_number": "563-556-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 DODGE ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037123",
            "telephone_number": "563-556-3555",
            "fax_number": "563-556-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C WERTZ DDS MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WERTZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-556-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IA",
            "license": "5979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128256",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.