NPIMap

Organization Active NPI

McCullough Family Dentistry, P.C.

  • Dental Clinic/Center
  • Ankeny, IA
National Provider Identifier
1730356148
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
7932 Issued in IA
Legal business name
MCCULLOUGH FAMILY DENTISTRY, P.C.
Practice address
1630 SW White Birch Cir
Ankeny, IA 50023-7213
Phone
(515) 965-4470
NPI assigned
May 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. Matthew McCullough
Title
Owner
Phone
(515) 965-4470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 7932 IA Primary

Addresses

Primary practice location

1630 SW White Birch Cir
Ankeny, IA 50023-7213

Mailing address

1630 SW White Birch Cir
Ankeny, IA 50023-7213
Phone (515) 965-4470

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1730356148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 SW WHITE BIRCH CIR",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237213",
            "telephone_number": "515-965-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SW WHITE BIRCH CIR",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237213",
            "telephone_number": "515-965-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCULLOUGH FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-965-4470",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "7932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.