Organization Active NPI

Ia Dental PC

Doing business as Aspen Dental

  • General Practice Dentistry
  • Waterloo, IA
National Provider Identifier
1740523471
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08595 Issued in IA
Legal business name
IA DENTAL PC
Doing business as
Aspen Dental
Practice address
2765 Crossroads Blvd
Waterloo, IA 50702-4409
Phone
(319) 233-2400
Fax
(319) 234-0569
NPI assigned
Apr 1, 2013
Last updated
Apr 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
Arwinder Singh Judge, DDS
Title
Owner
Phone
(866) 273-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08595 IA Primary

Addresses

Primary practice location

2765 Crossroads Blvd
Waterloo, IA 50702-4409

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (866) 273-8204

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2765 Crossroads Blvd
Waterloo, IA 50702
Phone (319) 233-2400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1740523471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 CROSSROADS BLVD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507024409",
            "telephone_number": "319-233-2400",
            "fax_number": "319-234-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IA DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "JUDGE",
        "authorized_official_first_name": "ARWINDER",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-273-8204",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.