NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION (NPI# 1003919135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003919135 |
| Entity Type | Organization |
| Organization Name | NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION |
| Other Organization Name | FAMILY DENTISTRY ASSOCIATES OF MONONA |
| Practice Address |
101 Franklin Monona IA 52159 |
| Mailing Address |
Po Box 965 Monona IA 52159 |
| Practice Telephone | 5635394651 |
| Practice Fax Number | 5635394653 |
| Mailing Telephone | 5635394651 |
| Mailing Fax Number | 5635394653 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2008-12-18 |
| Authorized Official Name | MRS. JUDY SUE KURTH (OFFICE MANAGER) |
| Authorized Official Telephone | 5635683983 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Family Dentistry Associates of Monona | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720173990 | Northeast Iowa Dental Professional Corporation | Dentist | 18 1st Ave Nw, Waukon, IA 52172 | 2006-10-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION | 18 St Ave Nw, Waukon, IA 52172 |
| Street Address |
101 FRANKLIN |
| City | MONONA |
| State | IA |
| Zip Code | 52159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780787374 | Mark Gary Fohey | Dentist | 101 Franklin, Monona, IA 52159 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982647053 | City of Monona | Assisted Living Facility | 800 Darby Drive, Monona, IA 52159 | 2006-06-14 |
| 1164459053 | Mfl Ambulance Service, Inc. | Ambulance | 108 S Page St, Monona, IA 52159-0065 | 2006-06-27 |
| 1972652295 | Mfl Marmac Csd | Local Education Agency (LEA) | 700 South Page Street, Monona, IA 52159-0544 | 2007-01-09 |
| 1760719686 | Barbara L Berns | Nurse Practitioner | Po Box Z, Monona, IA 52159-0562 | 2009-11-13 |
| 1154431872 | Pamela Sue Schweitzer | Dentist | 100 South Page Street, Monona, IA 52159-0858 | 2006-08-30 |
| 1255850970 | Lori Rae Vlazny | Nurse Practitioner | 101 Franklin St, Monona, IA 52159-8092 | 2017-09-13 |
| 1184030355 | Jessica Marie Wilke | Dentist | 101 Franklin St, Monona, IA 52159-8092 | 2014-07-08 |
| 1255327334 | Todd Eric Hanson | Chiropractor | 202 Franklin St, Monona, IA 52159-8219 | 2005-09-23 |
| 1245393263 | Nudak Ventures LLC | Durable Medical Equipment & Medical Supplies | 118 W Center St, Monona, IA 52159-8224 | 2006-12-19 |
| 1104145630 | Darcy Denise Weller | Registered Nurse | 403 W Center St, Monona, IA 52159-8225 | 2010-05-24 |
| Find all providers in zip 52159 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821264300 | Monona Riverplace Dental, LLC | Dentist | 604 River Pl, Monona, WI 53716-4034 | 2008-05-05 |
| 1568524825 | Complete Family Dentistry of Madison LLC | Dentist | 4925 Monona Dr, Monona, WI 53716-2634 | 2006-12-14 |
| 1104913730 | William A Lee | Dentist | 802 W Broadway, #320, Monona, WI 53713-1821 | 2006-10-06 |
| 1730125493 | Kendra Schaefer | Dentist | 612 River Pl, Monona, WI 53716-4034 | 2006-06-21 |
| 1225352883 | Joann Marie Miller | Dentist | 100 River Pl, Monona, WI 53716-4041 | 2010-03-25 |
| 1952531741 | Gregory Wipperfurth | Dentist | 100 River Pl, Suite 220, Monona, WI 53716-4041 | 2009-07-15 |
| 1659492817 | Kathryn Giswold | Dentist | 502 River Pl, Monona, WI 53716-4033 | 2007-04-03 |
| 1104944008 | Richard H Teteak | Dentist | 502 River Pl, Monona, WI 53716-4033 | 2007-03-27 |
| 1922122100 | Grace Yang Wenham | Dentist | 100 River Pl, Suite 110, Monona, WI 53716-4041 | 2007-03-16 |
| 1063574408 | Robert Charles Knutson | Dentist | 4925 Monona Dr, Monona, WI 53716-2634 | 2006-12-14 |
| Find all providers in MONONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.