Prairie Endodontics PLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

PRAIRIE ENDODONTICS PLC

Doing business as

Prairie Endodontics PLC

Practice address

1358 SE University Ave
Waukee, IA 50263-8933

Phone

(515) 393-2556

Fax

(515) 393-6782

NPI assigned

Sep 27, 2022

Last updated

Sep 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael McCunniff, D.D.S.NPI 1245783430

Title

Owner

Phone

(319) 939-4105

Specialties & licenses 1

Addresses

Other names 1

• Prairie Endodontics PLC Doing business as

Locations

Practitioners 1

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.

• Michael Lee McCunniff, DDS

  • Endodontics
  • Waukee, IA
  • NPI 1245783430
  NPD Authorized official

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1477277101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 SE UNIVERSITY AVE",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502638933",
            "telephone_number": "515-393-2556",
            "fax_number": "515-393-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 SE UNIVERSITY AVE",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502638933",
            "telephone_number": "515-393-2556",
            "fax_number": "515-393-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE ENDODONTICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "MCCUNNIFF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-939-4105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Endodontics PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endodontics in Waukee, IA
• Providers in Waukee, IA by specialty
• Endodontics in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.