Hill Avenue Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HILL AVENUE DENTAL LLC

Doing business as

Hill Avenue Dental

Practice address

1510 Hill Ave Ste D
Spirit Lake, IA 51360-1676

Phone

(712) 336-4895

NPI assigned

Mar 22, 2024

Last updated

Mar 22, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

VIDENTA, LLCAs reported in NPPES

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

Authorized official

Name

Lucas Bland

Title

Coo

Phone

(515) 577-6367

Specialties & licenses 1

Addresses

Other names 1

• Hill Avenue Dental Doing business as

Part of

Videnta LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Videnta, LLC

  • General Practice Dentistry
  • Ankeny, IA
  • NPI 1851175780
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darren James Dotson, DDS

  • General Practice Dentistry
  • Spirit Lake, IA
  • NPI 1649374901
  NPD (past)
• Amy Erika Hartzell, DDS

  • Dentist
  • Spirit Lake, IA
  • NPI 1104987593
  NPD (past)
• Dale Gene Palmberg, DDS

  • General Practice Dentistry
  • Spirit Lake, IA
  • NPI 1639284292
  NPD (past)

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1376303503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 N ANKENY BLVD",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234002",
            "telephone_number": "515-577-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 HILL AVE STE D",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513601676",
            "telephone_number": "712-336-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILL AVENUE DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIDENTA, LLC",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "BLAND",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-577-6367"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hill Avenue Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Lynn Henrickson
• Mara Groom Hermiston, D.O.
• Ann Elizabeth Hess, LMHC
• Megan Heyer
• Hill Avenue Chiropractic Inc.
• Jacob William Hindman, D.D.S
• Brooke Horsman, OTD
• Hy-Vee Inc (Hy-Vee Pharmacy (1628))
• Kimberly Ann Ingwersen
• Kyle Ingwersen, DPT

• General Practice Dentistry in Spirit Lake, IA
• Providers in Spirit Lake, IA by specialty
• General Practice Dentistry in Iowa

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