Elizabeth Pfohl

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS-09682 Issued in IA

Practice address

4207 Glass Rd NE
Cedar Rapids, IA 52402-2538

Phone

(192) 948-1813

Fax

(319) 261-8182

NPI assigned

Feb 28, 2019

Last updated

Jul 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: epfohl831031@direct.unitypoint.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1740747583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 GLASS RD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022538",
            "telephone_number": "319-294-8181",
            "fax_number": "319-261-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 GLASS RD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022538",
            "telephone_number": "192-948-1813",
            "fax_number": "319-261-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFOHL",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "DDS-09682",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "09682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DDS-09682",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stewart Peterson
• Caroline Petrik, T-LMFT
• Morgan Cecilia Petsche
• Abigail Seagle Petty, AUD
• Taylor Pflughaupt, DPT
• Khanh Phan, PHARMD
• Ryan Phelan, PHARMD
• Physical Medicine & Rehabilitation Associates of Northeast Iowa, Inc
• Physicians Choice Diagnostic Sleep Center, LLC
• Physicians Clinic of Iowa, PC (Iowa Blood and Cancer Care of PCI Medication Dispensing Service)

• Pediatric Dentistry in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Pediatric Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.