NPIMap

Organization Active NPI

Family Smilecare Center

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1841231644
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
07308 Issued in IA
Legal business name
FAMILY SMILECARE CENTER
Practice address
1630 32ND St NE
Cedar Rapids, IA 52402
Phone
(319) 362-8657
Fax
(319) 362-1824
NPI assigned
Jun 10, 2006
Last updated
Jul 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Dr. Renee Elaine Maikon, DDSNPI 1649211442
Title
Dentist Owner
Phone
(319) 362-8657

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7308 IA
General Practice Dentistry 1223G0001X 4870 IA
General Practice Dentistry 1223G0001X 07308 IA Primary
General Practice Dentistry 1223G0001X 08065 IA

Addresses

Primary practice location

1630 32ND St NE
Cedar Rapids, IA 52402

Mailing address

1630 32ND St NE
Cedar Rapids, IA 52402
Phone (319) 362-8657

Other identifiers 2

IdentifierTypeStateIssuer
0247759MedicaidIA
55943OtherIABLUE CROSS

Other names 1

  • Renee Maikon, DDS Other name

National Provider Directory

National Provider Directory

Locations

1630 32nd St NE
Cedar Rapids, IA 52402
Phone (319) 362-8657

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1841231644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 32ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-362-8657",
            "fax_number": "319-362-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 32ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-362-8657",
            "fax_number": "319-362-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SMILECARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "MAIKON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "319-362-8657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7308",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "4870",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07308",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0247759",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "55943",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renee Maikon, DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.