NPIMap

Organization Active NPI

Audubon Dental Center LLC

  • Dentist
  • Audubon, IA
National Provider Identifier
1477098648
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08747 Issued in IA
Legal business name
AUDUBON DENTAL CENTER LLC
Practice address
400 N Park PL
Audubon, IA 50025-1239
Phone
(712) 563-2659
Fax
(712) 563-2659
NPI assigned
Dec 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

Name
Dr. Brian Gerald Fleshner, D.D.S.NPI 1417269374
Title
Dentist/Owner
Phone
(712) 563-2659

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 08747 IA Primary

Addresses

Primary practice location

400 N Park PL
Audubon, IA 50025-1239

Mailing address

400 N Park PL
Audubon, IA 50025-1239
Phone (712) 563-2659

National Provider Directory

National Provider Directory

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1477098648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PARK PL",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251239",
            "telephone_number": "712-563-2659",
            "fax_number": "712-563-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PARK PL",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251239",
            "telephone_number": "712-563-2659",
            "fax_number": "712-563-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDUBON DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "FLESHNER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "712-563-2659",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "08747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.