NPIMap

Organization Active NPI

Fishomen P.C.

  • General Practice Dentistry
  • West Des Moines, IA
National Provider Identifier
1700053006
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
07198 Issued in IA
Legal business name
FISHOMEN P.C.
Practice address
4100 University Ave
#105
West Des Moines, IA 50266-5956
Phone
(515) 223-8800
Fax
(515) 223-1437
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Phelan Rico Thomas, DDSNPI 1144393034
Title
President
Phone
(515) 223-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 07198 IA Primary

Addresses

Primary practice location

4100 University Ave
#105
West Des Moines, IA 50266-5956

Mailing address

4100 University Ave
#105
West Des Moines, IA 50266-5956
Phone (515) 223-8800

Other names 1

  • iowa center for cosmetic dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4100 University Ave
Ste 105
West Des Moines, IA 50266
Phone (515) 223-8800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1700053006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 UNIVERSITY AVE",
            "address_2": "#105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665956",
            "telephone_number": "515-223-8800",
            "fax_number": "515-223-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 UNIVERSITY AVE",
            "address_2": "#105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665956",
            "telephone_number": "515-223-8800",
            "fax_number": "515-223-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHOMEN P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "PHELAN",
        "authorized_official_middle_name": "RICO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-223-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iowa center for cosmetic dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.