NPIMap

Organization Active NPI

Iowa Dental Health Professionals, P.C.

  • Dentist
  • Bettendorf, IA
National Provider Identifier
1619352010
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IOWA DENTAL HEALTH PROFESSIONALS, P.C.
Practice address
5201 Competition Dr
Bettendorf, IA 52722-8837
Phone
(563) 362-3705
NPI assigned
Jul 27, 2015
Organization subpart
Yes
Parent organization
IOWA DENTAL HEALTH PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5201 Competition Dr
Bettendorf, IA 52722-8837

Mailing address

5201 Competition Dr
Bettendorf, IA 52722-8837

Other names 1

  • Dental Care at The Plex Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Iowa Dental Professionals PC14 organizations share this tax ID, including this one
Part of
Iowa Dental Professionals PC

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

888 Middle Rd
Bettendorf, IA 52722
Phone (563) 205-6690

5201 Competition Dr
Bettendorf, IA 52722
Phone (563) 362-3705

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": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1619352010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 COMPETITION DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527228837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 COMPETITION DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527228837",
            "telephone_number": "563-362-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA DENTAL HEALTH PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA DENTAL HEALTH PROFESSIONALS, P.C.",
        "enumeration_date": "2015-07-27",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at The Plex",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.