Organization Active NPI

Dentistry for Children of Iowa PLLC

  • Pediatric Dentistry
  • Urbandale, IA
National Provider Identifier
1700395365
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DENTISTRY FOR CHILDREN OF IOWA PLLC
Practice address
2401 128TH St
Urbandale, IA 50323-1816
Phone
(770) 692-1000
NPI assigned
Sep 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Tamonia Leonard
Title
Credentialing Specialist
Phone
(678) 244-4844

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

2401 128TH St
Urbandale, IA 50323-1816

Mailing address

1350 Spring St NW Ste 600
Atlanta, GA 30309-2870

National Provider Directory

National Provider Directory

Locations

2401 128th St
Urbandale, IA 50323
Phone (515) 800-4073

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": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1700395365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SPRING ST NW STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 128TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503231816",
            "telephone_number": "770-692-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN OF IOWA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "TAMONIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "678-244-4844"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.