Organization Active NPI

Skyline Dental Services, LLC

  • General Practice Dentistry
  • Davenport, IA
National Provider Identifier
1952958167
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SKYLINE DENTAL SERVICES, LLC
Doing business as
Ear 2 Ear Smiles
Practice address
2180 W Kimberly Rd # 8
Davenport, IA 52806-5368
Phone
(630) 881-3925
NPI assigned
Aug 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Sean S Schaefer
Title
Manager
Phone
(630) 881-3925

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2180 W Kimberly Rd # 8
Davenport, IA 52806-5368

Mailing address

2180 W Kimberly Rd # 8
Davenport, IA 52806-5368

Other names 1

  • Ear 2 Ear Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

2180 W Kimberly Rd
#8
Davenport, IA 52806
Phone (630) 881-3925

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1952958167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 W KIMBERLY RD # 8",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 W KIMBERLY RD # 8",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065368",
            "telephone_number": "630-881-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE DENTAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-881-3925"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ear 2 Ear Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ear 2 Ear Smiles",
            "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 Feb 6, 2020; 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.