Organization Active NPI

Dague Dental Solutions

  • Dentist
  • Davenport, IA
National Provider Identifier
1740756139
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DAGUE DENTAL SOLUTIONS
Practice address
4711 N Brady St Ste 5S
Davenport, IA 52806-3955
Phone
(563) 386-9770
NPI assigned
Oct 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Authorized official

Name
Dr. Jolene Marie Dague, DDS
Title
Owner
Phone
(563) 357-4917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4711 N Brady St Ste 5S
Davenport, IA 52806-3955

Mailing address

6446 Caves Rd
Maquoketa, IA 52060-9795
Phone (563) 357-4917

Other identifiers 1

IdentifierTypeStateIssuer
1083878896MedicaidIA

National Provider Directory

National Provider Directory

Locations

4711 N Brady St
Ste 5S
Davenport, IA 52806
Phone (563) 386-9770

Practitioners & affiliated clinicians

Practitioners 1

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": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1740756139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6446 CAVES RD",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520609795",
            "telephone_number": "563-357-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 N BRADY ST STE 5S",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063955",
            "telephone_number": "563-386-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAGUE DENTAL SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "DAGUE",
        "authorized_official_first_name": "JOLENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-357-4917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083878896",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.