Active NPI
Howard Mark Trunnell, DDS
- General Practice Dentistry
- Cedar Falls, IA
National Provider Identifier
1679615041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6208
- Practice address
- 3722 Cedar Heights Dr
Cedar Falls, IA 50613-6207 - Phone
- (319) 266-7559
- Fax
- (319) 277-5140
- NPI assigned
- Feb 13, 2007
- Last updated
- Dec 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 06208 | IA | |
| General Practice Dentistry | 1223G0001X | 6208 | IA | Primary |
Addresses
Primary practice location
3722 Cedar Heights Dr
Cedar Falls, IA 50613-6207
Mailing address
922 Rainbow Dr
Cedar Falls, IA 50613-6500
Phone (319) 266-7559
Other practice location 1
105 20th St NW
Waverly, IA 50677-2059
Phone (319) 352-4488
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0143206 | Medicaid | IA | |
| 1679615041 | Medicaid | IA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://app.sfaxme.com/default.aspx | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06208 | IA | MD | General Practice Dentistry |
| 6208 | IA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cedar Valley Dental Associates PC | General Practice | Past | Accepting new patients |
| BT Sleep LLC | Past | Accepting new patients | |
| BT Sleep LLC | Past | Accepting new patients | |
| Cedar Valley Dental Associates PC | General Practice | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Cedar Falls, IA
- NPI 1376913343
-
- Dental Clinic/Center
- Cedar Falls, IA
- NPI 1598145690
-
- General Practice Dentistry
- Parkersburg, IA
- NPI 1376103390
-
- General Practice Dentistry
- Cedar Falls, IA
- NPI 1699981233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1679615041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "922 RAINBOW DR",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506136500",
"telephone_number": "319-266-7559",
"fax_number": "319-277-5140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3722 CEDAR HEIGHTS DR",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506136207",
"telephone_number": "319-266-7559",
"fax_number": "319-277-5140"
}
],
"practiceLocations": [
{
"address_1": "105 20th St NW",
"address_purpose": "LOCATION",
"city": "Waverly",
"state": "IA",
"postal_code": "506772059",
"country_code": "US",
"telephone_number": "319-352-4488",
"fax_number": "844-790-8096",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRUNNELL",
"first_name": "HOWARD",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "06208",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "6208",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0143206",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679615041",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://app.sfaxme.com/default.aspx",
"affiliation": "N",
"endpointDescription": "Secure fax",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "fax",
"address_1": "3722 Cedar Heights Dr",
"city": "Cedar Falls",
"state": "IA",
"country_code": "US",
"postal_code": "506136207",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cedar Falls, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.