Active NPI
Kaisha Heemskerk, D.D.S.
- Dentist
- Waukee, IA
National Provider Identifier
1508217878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 09315
- Practice address
- 350 E Hickman Road
Waukee, IA 50263 - Phone
- (515) 777-7568
- Fax
- (515) 777-7569
- NPI assigned
- Jun 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 09315 | IA | Primary |
Addresses
Primary practice location
350 E Hickman Road
Waukee, IA 50263
Mailing address
350 E Hickman Rd
Waukee, IA 50263-5005
Phone (515) 777-7568
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09315 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1508217878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 E HICKMAN RD",
"city": "WAUKEE",
"state": "IA",
"postal_code": "502635005",
"telephone_number": "515-777-7568",
"fax_number": "515-777-7569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 E HICKMAN ROAD",
"city": "WAUKEE",
"state": "IA",
"postal_code": "50263",
"telephone_number": "515-777-7568",
"fax_number": "515-777-7569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEEMSKERK",
"first_name": "KAISHA",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-28",
"last_updated": "2022-10-24",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "09315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukee, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.