Dale Gene Palmberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6335 Issued in IA

Practice address

1510 D Hill Avenue
Spirit Lake, IA 51360

Phone

(712) 336-4895

Fax

(712) 336-3336

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hill Avenue Dental LLC

  • General Practice Dentistry
  • Spirit Lake, IA
  • NPI 1376303503
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639284292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 D HILL AVENUE",
            "address_2": "PO BOX 448",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-4895",
            "fax_number": "712-336-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 D HILL AVENUE",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-4895",
            "fax_number": "712-336-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMBERG",
        "first_name": "DALE",
        "middle_name": "GENE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA",
            "identifier": "15139",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olson Bieri Christensen, DDS, PC
• Brett Joel Olson, M.D.
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• P B R Inc
• P.B.R., Inc.
• Shantel Diann Pausley, LMHC
• Jen Petersen, RPH
• Kayla Jo Plaehn, OTD, OTR/L
• Bradley Dean Poock, DC
• Charlotte Grace Powers, BSN, RN

• General Practice Dentistry in Spirit Lake, IA
• Providers in Spirit Lake, 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 Jul 8, 2007; 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.