Douglass J Soseman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06657 Issued in IA

Practice address

1415 Broadway
Denison, IA 51442-2052

Phone

(712) 263-5615

Fax

(712) 263-8124

NPI assigned

Oct 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Broadway Dental LLC

  • General Practice Dentistry
  • Denison, IA
  • NPI 1790816817
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376625764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BROADWAY",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422052",
            "telephone_number": "712-263-5615",
            "fax_number": "712-263-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BROADWAY",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422052",
            "telephone_number": "712-263-5615",
            "fax_number": "712-263-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSEMAN",
        "first_name": "DOUGLASS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184978",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Schleswig Community School District
• Keith A Schrunk, OD
• Segebart Chiropractic PLLC
• Jennifer Jean Seuntjens, RPH
• John W Sondag, L.M.H.C.
• St Anthony Regional Hospital and Nursing Home
• David Marc Tan Creti, MD
• Brooke Tasler, RD, LD
• Therapy and Healing Solutions LLC
• Kayla Marie Tiefenthaler, RD, LD

• General Practice Dentistry in Denison, IA
• Providers in Denison, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.