Individual provider Active NPI

Michael J. Flattery, D.D.S.

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1497823157
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7205 Issued in IA
Practice address
2505 Wedgewood Rd
Des Moines, IA 50317-6027
Phone
(515) 265-1406
Fax
(515) 265-5060
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7205 IA Primary

Addresses

Primary practice location

2505 Wedgewood Rd
Des Moines, IA 50317-6027

Mailing address

2505 Wedgewood Rd
Des Moines, IA 50317-6027
Phone (515) 265-1406

Other identifiers 1

IdentifierTypeStateIssuer
0041426MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151120001526 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517267693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7205IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Foley Dental PLLC PastSince Jun 8, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1497823157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 WEDGEWOOD RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176027",
            "telephone_number": "515-265-1406",
            "fax_number": "515-265-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 WEDGEWOOD RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176027",
            "telephone_number": "515-265-1406",
            "fax_number": "515-265-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLATTERY",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041426",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.