Individual provider Active NPI

Bobbi J Laun, DDS

  • General Practice Dentistry
  • West Burlington, IA
National Provider Identifier
1811217045
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08707 Issued in IA
Practice address
1706 W Agency Rd
West Burlington, IA 52655-1667
Phone
(319) 768-5858
Fax
(319) 753-2301
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08707 IA Primary

Addresses

Primary practice location

1706 W Agency Rd
West Burlington, IA 52655-1667

Mailing address

1706 W Agency Rd
West Burlington, IA 52655-1667
Phone (319) 768-5858

Other identifiers 2

IdentifierTypeStateIssuer
08707OtherIAST LIC
1255339750MedicaidIA

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
I20150413002183 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7810186731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1811217045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551667",
            "telephone_number": "319-768-5858",
            "fax_number": "319-753-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551667",
            "telephone_number": "319-768-5858",
            "fax_number": "319-753-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUN",
        "first_name": "BOBBI",
        "middle_name": "J",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LIC",
            "identifier": "08707",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255339750",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.