Active NPI
Robert Sidney Perry, DDS
- Dentist
- Council Bluffs, IA
National Provider Identifier
1912969866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6274
- Practice address
- 532 1St Avenue
Suite 210
Council Bluffs, IA 51503-0803 - Phone
- (712) 322-3974
- Fax
- (712) 329-4015
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6274 | IA | Primary |
Addresses
Primary practice location
532 1St Avenue
Suite 210
Council Bluffs, IA 51503-0803
Mailing address
532 1St Avenue
Suite 210
Council Bluffs, IA 51503-0803
Phone (712) 322-3974
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0141812 | Medicaid | IA |
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 |
|---|---|---|---|
| 06274 | IA | MD | Chiropractor |
| 6274 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1912969866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "532 1ST AVENUE",
"address_2": "SUITE 210",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515030803",
"telephone_number": "712-322-3974",
"fax_number": "712-329-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "532 1ST AVENUE",
"address_2": "SUITE 210",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515030803",
"telephone_number": "712-322-3974",
"fax_number": "712-329-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "ROBERT",
"middle_name": "SIDNEY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "6274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0141812",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, 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.