NPIMap

Organization Active NPI

Peosta Dental

  • Dentist
  • Peosta, IA
National Provider Identifier
1508023375
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08417 Issued in IA
Legal business name
PEOSTA DENTAL
Practice address
8558 Kapp Dr
Peosta, IA 52068-9759
Phone
(563) 557-1563
Fax
(563) 583-0581
NPI assigned
May 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. Austin Barrett Reed, D.D.SNPI 1790873263
Title
Dentist
Phone
(563) 557-1563

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 08417 IA Primary

Addresses

Primary practice location

8558 Kapp Dr
Peosta, IA 52068-9759

Mailing address

8558 Kapp Dr
Peosta, IA 52068-9759
Phone (563) 557-1563

Other identifiers 1

IdentifierTypeStateIssuer
0493965MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1508023375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 KAPP DR",
            "city": "PEOSTA",
            "state": "IA",
            "postal_code": "520689759",
            "telephone_number": "563-557-1563",
            "fax_number": "563-583-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8558 KAPP DR",
            "city": "PEOSTA",
            "state": "IA",
            "postal_code": "520689759",
            "telephone_number": "563-557-1563",
            "fax_number": "563-583-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOSTA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "BARRETT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "563-557-1563",
        "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": "08417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0493965",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peosta, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.