Dubuque Dermatology P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

21029 Issued in IA

Legal business name

DUBUQUE DERMATOLOGY P.C.

Practice address

2140 JFK Rd
Suite a
Dubuque, IA 52002-3883

Phone

(563) 582-9306

Fax

(563) 582-6879

NPI assigned

Sep 25, 2007

Last updated

Sep 25, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenzo Sato, M.D.

Title

Owner

Phone

(563) 582-9306

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1689860504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 JFK RD",
            "address_2": "SUITE A",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023883",
            "telephone_number": "563-582-9306",
            "fax_number": "563-582-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 JFK RD",
            "address_2": "SUITE A",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023883",
            "telephone_number": "563-582-9306",
            "fax_number": "563-582-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBUQUE DERMATOLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "SATO",
        "authorized_official_first_name": "KENZO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-582-9306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "21029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1148981",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dubuque Community School District
• Dubuque County Hospital (Sunnycrest Manor)
• Dubuque County Hospital (Sunnycrest Manor ICF/IID)
• Dubuque Dental Associates
• Dubuque Dental Enterprises, PLLC
• Dubuque Emergency Physicians PC
• Dubuque Endodontics, PC
• Dubuque Endoscopy Center LC
• Dubuque ENT Head & Neck Surgery P.C.
• Dubuque Family Chiropractic P.L.L.C.

• Specialist in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.