North Liberty Smiles PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NORTH LIBERTY SMILES PLLC

Practice address

2 Hawkeye Dr Ste 104
North Liberty, IA 52317-8202

Phone

(319) 665-3373

NPI assigned

Mar 13, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Pe Chang, DDS

Title

Owner

Phone

(319) 665-3373

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1912466582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 VISTA DEL NORTE RD NE APT 1526",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131364",
            "telephone_number": "505-980-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HAWKEYE DR STE 104",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178202",
            "telephone_number": "319-665-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LIBERTY SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-665-3373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093813354",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amin Nekoomand, D.C.
• Kaitlin Christine Nelson, PA-C
• North Liberty Clinic of Chiropractic, P.L.C.
• North Liberty Dental Services P.C.
• North Liberty Family Health Centre, P.C.
• Byron Ezeugo Nwonye, DC
• Shellie Marie O'Brien-Perry, ARNP-C
• Geoffrey Ounda Obel
• Ellen Rose Obrien, LMT, CLC
• Christopher Gene Okiishi, MD

• General Practice Dentistry in North Liberty, IA
• Providers in North Liberty, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.