NPIMap

Organization Active NPI

Design Dental, Inc.

  • Dental Clinic/Center
  • North Liberty, IA
National Provider Identifier
1740649912
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
207719 Issued in IA
Legal business name
DESIGN DENTAL, INC.
Practice address
115 N. Hwy 965
North Liberty, IA 52317
Phone
(319) 626-2222
Fax
(319) 626-6610
NPI assigned
Feb 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Dr. Shin-Ing Jeremy Tu, DDSNPI 1790871531
Title
Owner
Phone
(319) 626-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 207719 IA Primary

Addresses

Primary practice location

115 N. Hwy 965
North Liberty, IA 52317

Mailing address

115 N. Hwy 965
PO Box 915
North Liberty, IA 52317
Phone (319) 626-2222

Other identifiers 2

IdentifierTypeStateIssuer
0279349MedicaidIA
1790871531OtherIANPI

National Provider Directory

National Provider Directory

Locations

115 Highway 965 NE
North Liberty, IA 52317
Phone (319) 626-2222

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1740649912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N. HWY 965",
            "address_2": "PO BOX 915",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "52317",
            "telephone_number": "319-626-2222",
            "fax_number": "319-626-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N. HWY 965",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "52317",
            "telephone_number": "319-626-2222",
            "fax_number": "319-626-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIGN DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "TU",
        "authorized_official_first_name": "SHIN-ING",
        "authorized_official_middle_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-626-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "207719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0279349",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790871531",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.