Ablm Northeast Profesional Association

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ABLM NORTHEAST PROFESIONAL ASSOCIATION

Doing business as

ABLM Family Dental Center

Practice address

2116 Logan Ave
Waterloo, IA 50703-1006

Phone

(319) 235-1151

Fax

(319) 235-2804

NPI assigned

Nov 30, 2006

Last updated

Aug 22, 2020By 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. Marvin C. Vore, DDS

Title

Partner

Phone

(319) 235-1151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ABLM Family Dental Center Doing business as

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710054994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031006",
            "telephone_number": "319-235-1151",
            "fax_number": "319-235-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031006",
            "telephone_number": "319-235-1151",
            "fax_number": "319-235-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABLM NORTHEAST PROFESIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VORE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "319-235-1151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008052",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABLM Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Waterloo, IA
• Providers in Waterloo, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.