Active NPI
Myra M Lussman, DDS
- Pediatric Dentistry
- West Des Moines, IA
National Provider Identifier
1821054487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 7920
- Practice address
- 4090 Westown Pkwy
Suit B
West Des Moines, IA 50266-6760 - Phone
- (515) 267-0737
- Fax
- (515) 267-1480
- NPI assigned
- Apr 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 7920 | IA | Primary |
Addresses
Primary practice location
4090 Westown Pkwy
Suit B
West Des Moines, IA 50266-6760
Mailing address
4090 Westown Pkwy
Suit B
West Des Moines, IA 50266-6760
Phone (515) 267-0737
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7920 | IA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1821054487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4090 WESTOWN PKWY",
"address_2": "SUIT B",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502666760",
"telephone_number": "515-267-0737",
"fax_number": "515-267-1480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4090 WESTOWN PKWY",
"address_2": "SUIT B",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502666760",
"telephone_number": "515-267-0737",
"fax_number": "515-267-1480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSSMAN",
"first_name": "MYRA",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IA",
"license": "7920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.