Ivan King Salmons, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

05821 Issued in IA

Practice address

1855 Indian Hills Dr
Sioux City, IA 51104-1517

Phone

(712) 239-5900

NPI assigned

Nov 1, 2006

Last updated

Mar 19, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sioux City Family Dentistry

  • Dental Clinic/Center
  • Sioux City, IA
  • NPI 1902670821
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1952488645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 INDIAN HILLS DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041517",
            "telephone_number": "712-239-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 INDIAN HILLS DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041517",
            "telephone_number": "712-239-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMONS",
        "first_name": "IVAN",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "05821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005215",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammad Amr Sabbagh, MD
• Holly Marie Sachau
• Kelly Jean Sachau, LMHC
• Sacred Encounter Hospice NW Iowa, LLC (Sacred Encounter Hospice)
• Shawn Rene Salmen, NP-C
• Tiffany Samuelson, LMSW, CADC
• William Oliver Samuelson, MD
• Castelia Y Sanchez
• Hilary Nicole Sanchez, OTD,OTR/L
• Raul Sanchez, PH.D

• General Practice Dentistry in Sioux City, IA
• Providers in Sioux City, 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 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.