Carroll Dental Clinic P.L.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CARROLL DENTAL CLINIC P.L.C.

Practice address

703 Simon Ave
Carroll, IA 51401-2264

Phone

(712) 792-4375

Fax

(712) 792-3371

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Christopher William Bogue P.C., DDS

Title

Dentist

Phone

(712) 792-4375

Specialties & licenses 1

Addresses

Other names 1

• Lake View Family Dentistry & Manilla Family Dentistry Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher W Bogue, DDS

  • Dentist
  • Carroll, IA
  • NPI 1184771917
  NPD
• Katie N Jaffe, D.D.S.

  • Dentist
  • Carroll, IA
  • NPI 1891100673
  NPD (past)
• Jay Allen Tigges, DDS

  • General Practice Dentistry
  • Carroll, IA
  • NPI 1952034977
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1679620520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 SIMON AVE",
            "address_2": "PO BOX 997",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012264",
            "telephone_number": "712-792-4375",
            "fax_number": "712-792-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 SIMON AVE",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012264",
            "telephone_number": "712-792-4375",
            "fax_number": "712-792-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL DENTAL CLINIC P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "BOGUE P.C.",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "712-792-4375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake View Family Dentistry & Manilla Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carroll Co Council Prev Child Abuse
• Carroll Community School District
• Carroll County Case Management
• Carroll County County Auditor
• Carroll County Home Care Aide Service
• Carroll Eye Care Associates PC
• Carroll Eye Clinic PC
• Carroll Family Chiropractic Center
• Andrea Carrothers
• Toni Castillo

• All providers in Carroll, IA
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.