NPIMap

Organization Active NPI

Eastern Iowa Health Center

Doing business as Eastern Iowa Dental Center

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1437600053
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EASTERN IOWA HEALTH CENTER
Doing business as
Eastern Iowa Dental Center
Practice address
1210 4TH Ave SE
Cedar Rapids, IA 52403-4085
Phone
(319) 730-7300
NPI assigned
Oct 19, 2016
Last updated
Jun 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Authorized official

Name
James Lock
Title
Ceo
Phone
(319) 730-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

1210 4TH Ave SE
Cedar Rapids, IA 52403-4085

Mailing address

PO Box 2205
Cedar Rapids, IA 52406-2205
Phone (319) 730-7300

Other practice location 1

855 A Ave NE Ste Ll1
Cedar Rapids, IA 52402-5064
Phone (319) 730-7300

Other names 1

  • Eastern Iowa Dental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170718002013 IA Part A Provider - Federally Qualified Health Center (FQHC) 0648364828 Practice locations: Cedar Rapids, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437600053. Details of each certification follow.

Federally qualified health center certification: CCN 161874

Legal name
EASTERN IOWA HEALTH CENTER
Doing business as
EASTERN IOWA DENTAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 18, 2017
Last certification
Jul 18, 2017
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Feb 4, 2005 in IA
Enrollment address
1210 4TH Ave SE
Cedar Rapids, IA 52403-4085

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eastern Iowa Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1210 4th Ave SE
Cedar Rapids, IA 52403

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rachel Rockwell Individual Corporate DirectorBoard Member Jul 1, 2022
John E Brandt Individual Corporate DirectorBoard Member Jun 1, 2017
Evan J Diehl Individual Corporate DirectorBoard Member Jul 1, 2022
John Heavens Individual Corporate DirectorBoard Member Jul 1, 2022
Anthony C Eschliman Individual Corporate OfficerCmo Jul 1, 2022
W-2 Managing EmployeeCmo Jul 1, 2022
Martha Carter Individual Corporate DirectorBoard Member Jul 1, 2022
Connie Alt Individual Corporate DirectorBoard Director Jul 1, 2022
James J Lock Individual Corporate OfficerPresident & Ceo Jun 1, 2017
Leah Hanson Individual Corporate DirectorBoard Member Jul 1, 2022
John D Lipcamon Individual Corporate DirectorBoard Member Jun 1, 2017
Srikanth Sankar Ravisankar Individual Corporate DirectorBoard Member Jul 1, 2022
Kristin Parrott Individual Corporate DirectorBoard Member Jul 1, 2022
Leya Neema Individual Corporate DirectorBoard Member Jul 1, 2022
Dennis Goettel Individual Corporate DirectorBoard Member Jul 1, 2022
Ann E Hearn Individual Corporate DirectorBoard Member Jun 1, 2017
Ashley Balius Individual Corporate DirectorBoard Member Jul 1, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1437600053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2205",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524062205",
            "telephone_number": "319-730-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 4TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034085",
            "telephone_number": "319-730-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 A Ave NE Ste Ll1",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524025064",
            "country_code": "US",
            "telephone_number": "319-730-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTERN IOWA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "LOCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-730-7300"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Iowa Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.