NPIMap

Organization Active NPI

Ryan T Hajek DDS PC

  • Pediatric Dentistry
  • Council Bluffs, IA
National Provider Identifier
1730551268
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
09125 Issued in IA
Legal business name
RYAN T HAJEK DDS PC
Doing business as
Bayliss Park Dental Group
Practice address
114 1/2 S 6TH St
Council Bluffs, IA 51501-4234
Phone
(712) 256-5048
NPI assigned
Oct 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Authorized official

Name
Dr. Ryan Thomas Hajek, D.D.S.
Title
Owner
Phone
(605) 354-7077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 09125 IA Primary

Addresses

Primary practice location

114 1/2 S 6TH St
Council Bluffs, IA 51501-4234

Mailing address

114 1/2 S 6TH St
Council Bluffs, IA 51501-4234
Phone (712) 256-5048

Other names 1

  • Bayliss Park Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

114 S 6th St
Council Bluffs, IA 51501
Phone (712) 256-5048

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1730551268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 1/2 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515014234",
            "telephone_number": "712-256-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 1/2 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515014234",
            "telephone_number": "712-256-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN T HAJEK DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "HAJEK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-354-7077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "09125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayliss Park Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.