NPIMap

Organization Active NPI

Dentistry on 5TH

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1588082739
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08454 Issued in IA
Legal business name
DENTISTRY ON 5TH
Practice address
505 5TH Ave
Suite 939
Des Moines, IA 50309-2324
Phone
(515) 243-4616
NPI assigned
Apr 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Authorized official

Name
Leann Kim Sou
Title
Office Manager
Phone
(515) 243-4616

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 08454 IA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 08950 IA

Addresses

Primary practice location

505 5TH Ave
Suite 939
Des Moines, IA 50309-2324

Mailing address

505 5TH Ave
Suite 939
Des Moines, IA 50309-2324
Phone (515) 243-4616

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1588082739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 5TH AVE",
            "address_2": "SUITE 939",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092324",
            "telephone_number": "515-243-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 5TH AVE",
            "address_2": "SUITE 939",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092324",
            "telephone_number": "515-243-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY ON 5TH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "SOU",
        "authorized_official_first_name": "LEANN",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-243-4616"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08454",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08950",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.