Individual provider Active NPI

Kevin Henry Imoehl, DDS

  • Dentist
  • Oelwein, IA
National Provider Identifier
1417992256
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
IA07072 Issued in IA
Practice address
11 1St Ave NE
Oelwein, IA 50662
Phone
(319) 283-4738
Fax
(319) 283-4754
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IA07072 IA Primary

Addresses

Primary practice location

11 1St Ave NE
Oelwein, IA 50662

Mailing address

11 1St Ave NE
Oelwein, IA 50662
Phone (319) 283-4738

Other identifiers 2

IdentifierTypeStateIssuer
0039818MedicaidIA
24254OtherIABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IA07072IAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417992256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 1ST AVE NE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "50662",
            "telephone_number": "319-283-4738",
            "fax_number": "319-283-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 1ST AVE NE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "50662",
            "telephone_number": "319-283-4738",
            "fax_number": "319-283-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMOEHL",
        "first_name": "KEVIN",
        "middle_name": "HENRY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "IA07072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039818",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "24254",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oelwein, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.