Edwin Christian Siebrasse, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06644 Issued in IA

Practice address

303 SW 7TH St.
Suite D
Stuart, IA 50250

Phone

(515) 523-2521

Fax

(515) 523-2162

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649362906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SW 7TH ST.",
            "address_2": "SUITE D",
            "city": "STUART",
            "state": "IA",
            "postal_code": "50250",
            "telephone_number": "515-523-2521",
            "fax_number": "515-523-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SW 7TH ST.",
            "address_2": "SUITE D",
            "city": "STUART",
            "state": "IA",
            "postal_code": "50250",
            "telephone_number": "515-523-2521",
            "fax_number": "515-523-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBRASSE",
        "first_name": "EDWIN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0220905",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabra J Miller, APRN
• Ocular Care Professionals LLC
• Wilda Leella Orewiler, PAC
• Kacey M Peterson, MS, LMHC
• Angela May Schwinger, R.D.A. AND L.M.T.
• Stuart Family Dental PC
• Stuart Medical Clinic
• Town of Stuart (Stuart Rescue)
• West Central Valley CSD

• General Practice Dentistry in Stuart, IA
• Providers in Stuart, 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.