Dental Studio of Iowa PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL STUDIO OF IOWA PC

Practice address

5495 NW 100TH Street
Johnston, IA 50131

Phone

(515) 707-4383

NPI assigned

Aug 3, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Connor Elmitt, DDS

Title

President

Phone

(515) 707-4383

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1982182606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 NW HARVEST DR",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501112300",
            "telephone_number": "515-707-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5495 NW 100TH STREET",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "50131",
            "telephone_number": "515-707-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL STUDIO OF IOWA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "ELMITT",
        "authorized_official_first_name": "CONNOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-707-4383",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013329978",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942615232",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Mullin Delahunt, S.T.
• Lauren Delgado, ARNP, CNM
• Delight Medical Staffing Agency
• Vicki Demoss, MS,OTR/L, MPA
• Cheryl Denison-Miller, OTR-L, MS
• Des Moines Hearing and Speech
• Des Moines Wellness Center
• Des Moines Wellness Center LLC
• Swati Sahil Desai, PHARMD
• Diabetic Equipment and Supplies LLC

• All providers in Johnston, IA
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.