Nicholas Anthony Kubik, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

06785 Issued in IA

Practice address

1311 McClellan St
Tama, IA 52339

Phone

(641) 484-5561

NPI assigned

Oct 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689754285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418",
            "city": "TAMA",
            "state": "IA",
            "postal_code": "523390418",
            "telephone_number": "641-484-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 MCCLELLAN ST",
            "city": "TAMA",
            "state": "IA",
            "postal_code": "52339",
            "telephone_number": "641-484-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "NICHOLAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "06785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0195735",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Cullinan
• Judith K Dale, MSPT
• Amanda Heck, ARNP
• Randall W Inhelder, MSW
• Megan Marie Koehn, RDN, LD
• Alejandro Martinez
• Mary Malvina Means, RD LD MA
• Mercy Physician Associates, Inc (MercyCare Tama)
• Meskwaki Pharmacy
• Lou Ann Mitchell, M.D

• Dentist in Tama, IA
• Providers in Tama, IA by specialty
• Dentist 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.