NPIMap

Organization Active NPI

H Mark Trunnell DDS PC

  • Dentist
  • Waverly, IA
National Provider Identifier
1417166257
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6208 Issued in IA
Legal business name
H MARK TRUNNELL DDS PC
Practice address
325 21St St NW
Waverly, IA 50677-2019
Phone
(319) 352-4488
Fax
(319) 352-4489
NPI assigned
May 21, 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
Howard Mark Trunnell, DDS
Title
President
Phone
(319) 352-4488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6208 IA Primary

Addresses

Primary practice location

325 21St St NW
Waverly, IA 50677-2019

Mailing address

325 21St St NW
Waverly, IA 50677-2019
Phone (319) 352-4488

Other identifiers 1

IdentifierTypeStateIssuer
0143206MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
H Mark Trunnell DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417166257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 21ST ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772019",
            "telephone_number": "319-352-4488",
            "fax_number": "319-352-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 21ST ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772019",
            "telephone_number": "319-352-4488",
            "fax_number": "319-352-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H MARK TRUNNELL DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRUNNELL",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-352-4488",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "6208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143206",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, 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.