Iowa Oral and Maxillofacial Surgeons, PC

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

06447 Issued in IA

Legal business name

IOWA ORAL AND MAXILLOFACIAL SURGEONS, PC

Practice address

1469 29TH St
West Des Moines, IA 50266-1302

Phone

(515) 223-6529

Fax

(515) 223-5448

NPI assigned

Jan 24, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Diana Gail Weirich

Title

Insurance Coordinator

Phone

(515) 327-1647

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1609846583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1469 29TH ST",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661302",
            "telephone_number": "515-223-6529",
            "fax_number": "515-223-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 29TH ST",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661302",
            "telephone_number": "515-223-6529",
            "fax_number": "515-223-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA ORAL AND MAXILLOFACIAL SURGEONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "WEIRICH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "515-327-1647",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IA",
            "license": "06447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "22178",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Pathology Dentistry in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Oral and Maxillofacial Pathology Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.