Ingersoll Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

INGERSOLL FAMILY DENTISTRY

Practice address

2800 Ingersoll Ave
Des Moines, IA 50312-4013

Phone

(515) 243-2412

NPI assigned

Dec 16, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Bernard Lawrence Gradoville, D.D.S.NPI 1619958600

Title

Owner

Phone

(515) 243-2412

Specialties & licenses 1

Addresses

Other names 1

• Ingersoll Family Dentistry 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.

• Bernard L. Gradoville, D.D.S.

  • General Practice Dentistry
  • Des Moines, IA
  • NPI 1619958600
  NPD Authorized official

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1538828678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124013",
            "telephone_number": "515-243-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124013",
            "telephone_number": "515-243-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGERSOLL FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "GRADOVILLE",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-243-2412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ingersoll Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Enisa Imsirovic
• Nermin Imsirovic, ARNP
• Inclusive ABA Ia LLC
• Infinity Assessment Services LLC
• Ingersoll Dental Group PC
• Drew A Ingram, O.D.
• Kailey Ann Ingram, ARNP
• Kent Leslie Ingvalson, DPT
• Inner Health Services. Inc
• Innovative Counseling & Consulting, Inc.

• General Practice Dentistry in Des Moines, IA
• Providers in Des Moines, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.