Robert Ian Campbell Jr.
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Ottumwa, IA
NPI 1376930867 · NPPES record last updated Apr 23, 2024
Key facts
- NPI
- 1376930867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 09859 (IA)
- Practice address
- 1116 Pennsylvania Ave
Ottumwa, IA 52501-2109 - Phone
- (641) 682-2350
- NPI assigned
- Apr 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| I20150709000674 | IA | Order and Referring Only - Oral Surgery |
7810209590 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09859 | IA | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R. Ian Campbell D.D.S, PLLC | Oral and Maxillofacial Surgery | Current |
Accepting new patients |
| Gregory P. Vannucci D.D.S.,P.C. | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
Locations
1116 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 682-2350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 09859 | IA | Yes |
Addresses
Primary practice location
1116 Pennsylvania Ave
Ottumwa, IA 52501-2109
Mailing address
1369 Spruce PL Apt 1005
Minneapolis, MN 55403-2692
Phone (870) 816-5691
Other providers in Ottumwa, IA
- Ashley Lynn Brownlee
- David Ira Bunce
- Susan Burgdorf
- David Lee Burrows
- Kimberly Sue Burton
- Bethany Canny
- Jonathan Ellsworth Cardon
- Care Initiatives
- Carlenrose Corporation
- Tiffany Jo Carriker
All providers in Ottumwa, IA · Oral and Maxillofacial Surgery (Dentist) in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2024. 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.