Dyer Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DYER DENTAL, PLLC

Practice address

1255 Theatre Dr
Ottumwa, IA 52501-3779

Phone

(641) 954-3390

NPI assigned

Jul 21, 2023

Organization subpart

No

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

Authorized official

Name

Michelle Jacomino-Barnes

Title

Director Credentialing & Enrollment

Phone

(813) 270-9497

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1730869934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 THEATRE DR",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525013779",
            "telephone_number": "641-954-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYER DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "JACOMINO-BARNES",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR CREDENTIALING & ENROLLMENT",
        "authorized_official_telephone_number": "813-270-9497"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr Dennis M Gillespie
• Dr P O Swanson OD PC
• Dr. J. Brent Altfillisch, O.D. P.C.
• Cassandra Dunlavy, ARNP
• Holly Nicole Dunlavy, ARNP
• Jon Dyer, DDS
• Ear Nose Throat of Southeast Iowa, P.C.
• Heather E Easton, ARNP
• Michelle Edwards, LMHC
• Shelly Ann Edwards, ARNP

• General Practice Dentistry in Ottumwa, IA
• Providers in Ottumwa, 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 Sep 14, 2023; 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.