Individual provider Active NPI

Jessica L.K. Lawson, D.D.S.

  • Dentist
  • Urbandale, IA
National Provider Identifier
1790976421
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08512 Issued in IA
Practice address
4444 Northwest 128TH Street
Urbandale, IA 50323-1728
Phone
(515) 278-4366
Fax
(515) 278-4624
NPI assigned
Aug 7, 2007
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 08512 IA Primary

Addresses

Primary practice location

4444 Northwest 128TH Street
Urbandale, IA 50323-1728

Mailing address

4444 Northwest 128TH Street
Urbandale, IA 50323-1728
Phone (515) 278-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160311000405 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8527375500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08512IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lawson Dentistry Dentist CurrentSince Jul 6, 2005 Accepting new patients

Locations

4444 128th St
Urbandale, IA 50323
Phone (515) 278-4366

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1790976421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 NORTHWEST 128TH STREET",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503231728",
            "telephone_number": "515-278-4366",
            "fax_number": "515-278-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 NORTHWEST 128TH STREET",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503231728",
            "telephone_number": "515-278-4366",
            "fax_number": "515-278-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "JESSICA",
        "middle_name": "L.K.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.