Clifford Charles Collins, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

5937 Issued in IA

Practice address

215 W Ashland Ave
Indianola, IA 50125-2422

Phone

(515) 961-8186

NPI assigned

Apr 26, 2007

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952521445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 FAIRWAY DR",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501251070",
            "telephone_number": "515-962-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W ASHLAND AVE",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252422",
            "telephone_number": "515-961-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CLIFFORD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IA",
            "license": "5937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099390",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Carson, M.A., CCC-SLP
• Leslie Brooke Charleville, ARNP
• Ashley Chestnut, ARNP
• City of Indianola
• Michelle R Collette, ARNP
• Susan Comer, MD
• Compass Life Resources, LLC
• Michael Harvey Cooley
• Nanette K Cooley, RPH
• Thomas Ray Cooney, D.D.S.

• Orthodontics and Dentofacial Orthopedics Dentistry in Indianola, IA
• Providers in Indianola, IA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.