Active NPI
Friendly Dental
- Dental Clinic/Center
- Sibley, IA
National Provider Identifier
1639486285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- License
- 07092
- Legal business name
- FRIENDLY DENTAL
- Practice address
- 611 3Rd Ave
Sibley, IA 51249-1626 - Phone
- (712) 754-2288
- Fax
- (712) 754-4865
- NPI assigned
- Sep 2, 2010
- Organization subpart
- Yes
- Parent organization
- FRIENDLY DENTAL PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jari L Johnson
- Title
- Office Manager
- Phone
- (507) 376-5525
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 07092 | IA | Primary |
Addresses
Primary practice location
611 3Rd Ave
Sibley, IA 51249-1626
Mailing address
611 3Rd Ave
Sibley, IA 51249-1626
Phone (712) 754-2288
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922167410 | Other | MN | INDIVIDUAL NPI KELLY PHILLIPS, DDS |
| 1316975568 | Other | MN | INDIVIDUAL NPI JERRY L. JOHNSON, DDS |
| 1770672958 | Other | MN | PRIMARY LOCATION NPI |
National Provider Directory
National Provider Directory- Tax ID family
- Friendly Dental
- Part of
- Friendly Dental
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dental Clinic/Center
- Worthington, MN
- NPI 1770672958
Locations
611 3rd Ave
Sibley, IA 51249
Phone (712) 754-2288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1283385600000",
"number": "1639486285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 3RD AVE",
"city": "SIBLEY",
"state": "IA",
"postal_code": "512491626",
"telephone_number": "712-754-2288",
"fax_number": "712-754-4865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 3RD AVE",
"city": "SIBLEY",
"state": "IA",
"postal_code": "512491626",
"telephone_number": "712-754-2288",
"fax_number": "712-754-4865"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRIENDLY DENTAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FRIENDLY DENTAL PC",
"enumeration_date": "2010-09-02",
"last_updated": "2010-09-02",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "JARI",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "507-376-5525",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "IA",
"license": "07092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI KELLY PHILLIPS, DDS",
"identifier": "1922167410",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI JERRY L. JOHNSON, DDS",
"identifier": "1316975568",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIMARY LOCATION NPI",
"identifier": "1770672958",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sibley, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.