NPIMap

Organization Active NPI

Dental Professionals, PLC

  • General Practice Dentistry
  • Indianola, IA
National Provider Identifier
1780851972
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
07648J Issued in IA
Legal business name
DENTAL PROFESSIONALS, PLC
Practice address
200 N B St
Indianola, IA 50125-2429
Phone
(515) 961-8411
Fax
(515) 962-1810
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Gary L Jacobsen, DDSNPI 1205895166
Title
President
Phone
(515) 961-8411

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 07648J IA Primary

Addresses

Primary practice location

200 N B St
Indianola, IA 50125-2429

Mailing address

200 N B St
Indianola, IA 50125-2429
Phone (515) 961-8411

National Provider Directory

National Provider Directory

Locations

200 N B St
Indianola, IA 50125
Phone (515) 961-8411

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": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1780851972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N B ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252429",
            "telephone_number": "515-961-8411",
            "fax_number": "515-962-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N B ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252429",
            "telephone_number": "515-961-8411",
            "fax_number": "515-962-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-961-8411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07648J",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.