NPIMap

Organization Active NPI

Secure Dental II, LLC

Doing business as Secure Dental Davenport

  • Dentist
  • Davenport, IA
National Provider Identifier
1902258379
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SECURE DENTAL II, LLC
Doing business as
Secure Dental Davenport
Practice address
5025 Utica Ridge Rd
Suite 103
Davenport, IA 52807
Phone
(563) 345-8888
NPI assigned
Jul 8, 2016
Last updated
Jan 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Authorized official

Name
Dr. Nazish JafriNPI 1538447321
Title
Owner Dentist
Phone
(563) 345-8888

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5025 Utica Ridge Rd
Suite 103
Davenport, IA 52807

Mailing address

3127 N University St
Peoria, IL 61604-1316
Phone (309) 681-8888

Other names 1

  • Secure Dental Davenport Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Secure Dental Davenport2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5025 Utica Ridge Rd
Ste 103
Davenport, IA 52807
Phone (563) 345-8888

Practitioners & affiliated clinicians

Practitioners 11

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": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1902258379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041316",
            "telephone_number": "309-681-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 UTICA RIDGE RD",
            "address_2": "SUITE 103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52807",
            "telephone_number": "563-345-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE DENTAL II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "JAFRI",
        "authorized_official_first_name": "NAZISH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "563-345-8888",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Secure Dental Davenport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.