IOWA PEDIATRIC DENTAL CENTER II LLC (NPI# 1245656800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245656800 |
Entity Type | Organization |
Organization Name | IOWA PEDIATRIC DENTAL CENTER II LLC |
Practice Address |
5350 Kirkwood Blvd Sw Suite 700 Cedar Rapids IA 52404-5233 |
Practice Telephone | 3193660600 |
Practice Fax Number | 3193661316 |
Mailing Telephone | 3193660600 |
Mailing Fax Number | 3193661316 |
Enumeration Date | 2014-03-06 |
Last Update Date | 2014-03-06 |
Authorized Official Name | DR. DONALD CRAIG PETERSON JR. (DOCTOR/OWNER) |
Authorized Official Telephone | 3193660600 |
Authorized Official Credential | D.D.S. |
Is Organization Subpart | Y |
Parent Organization Name | IOWA PEDIATRIC DENTAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
08193 | IA | Dental Providers |
Street Address |
5350 KIRKWOOD BLVD SW SUITE 700 |
City | CEDAR RAPIDS |
State | IA |
Zip Code | 52404-5233 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285233064 | Physiotherapy Associates, Inc. | Clinic/Center | 998 Westdale Parkway, Cedar Rapids, IA 52404 | 2020-10-22 |
1528617313 | Humble Language Institute | Interpreter | 3513 Royal Dr. Sw, Cedar Rapids, IA 52404 | 2019-09-05 |
1073169074 | Jackie Lugene Mcfetridge | Technician | 3528 Falcon View Rd Sw, Cedar Rapids, IA 52404 | 2019-08-15 |
1003460312 | Rem Iowa, Inc. | Intermediate Care Facility, Mentally Retarded | 143 16th Ave Sw, Cedar Rapids, IA 52404 | 2019-07-25 |
1811541121 | Rem Iowa, Inc. | Intermediate Care Facility, Mentally Retarded | 2620 33rd Ave Sw, Cedar Rapids, IA 52404 | 2019-07-25 |
1659859569 | Wanda Marie Mokry-sellers | Counselor | 3601 16th Avenue Sw, Cedar Rapids, IA 52404 | 2018-08-02 |
1790231371 | Freddie Lederle | Taxi | 3260 Southgate Place, Cedar Rapids, IA 52404 | 2016-09-01 |
1619422748 | Mercy Physician Associates, Inc | Family Medicine | 777 76th Ave Dr Sw, Cedar Rapids, IA 52404 | 2016-08-18 |
1740638626 | Lasharon Leah Taylor | Counselor | 3330 Southgate Ct Sw, Cedar Rapids, IA 52404 | 2016-06-01 |
1689094112 | Pathway Counseling Center | Clinic/Center | 1073 Rockford Rd Se, Suite E, Cedar Rapids, IA 52404 | 2014-04-23 |
Find all providers in zip 52404 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497067698 | Sarah Elizabeth Swenson | Dentist | 1962 1st Avenue Ne, Cedar Rapids, IA 52402-5334 | 2010-07-06 |
1568476604 | Erik T Balster | Dentist | 4207 Glass Rd. Ne Suite 2, Cedar Rapids, IA 52402 | 2006-07-27 |
1780664870 | Curtis D Livengood | Dentist | 2727 First Ave Se, Cedar Rapids, IA 52402 | 2006-01-17 |
1285618181 | Michael Louis Walker | Dentist | 1962 First Ave Ne, Cedar Rapids, IA 52402 | 2005-12-05 |
1043755408 | Cedar Rapids Pediatric Dentistry LLC | Dentist | 1962 1st Ave Ne, Cedar Rapids Pediatric Dentistry, Cedar Rapids, IA 52402-5330 | 2016-12-21 |
1952789448 | Ursula Anne Diehl | Dentist | 1962 1st Ave Ne, Cedar Rapids, IA 52402-5330 | 2015-05-15 |
1598922247 | Balster Pediatric Dentistry, PC | Dentist | 4207 Glass Rd Ne, Ste 2, Cedar Rapids, IA 52402-2538 | 2008-05-20 |
1437316353 | Michael L. Walker, Dds, Ms | Dentist | 1962 1st Ave Ne, Cedar Rapids, IA 52402-5330 | 2008-05-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528681897 | The Children's Dental Center, Pllc | Dentist | 2761 Oakdale Blvd Ste 4, Coralville, IA 52241-9754 | 2020-05-21 |
1659934701 | Grimes Pediatric Dentistry P C | Dentist | 1551 Se 3rd St Ste 100, Grimes, IA 50111-8861 | 2019-04-15 |
1215316633 | Kaitlin Joy Hoogeveen | Dentist | 164 S Main Ave, Sioux Center, IA 51250-1536 | 2015-05-19 |
1760801062 | Diana Pelzer | Dentist | 1250 Se University Ave, Waukee, IA 50263-8831 | 2014-04-15 |
1528483716 | Peter Joseph Stanley | Dentist | 201 Dental Science Bldg S., Iowa City, IA 52242-1001 | 2014-02-24 |
1821433160 | Nicholas Wade Barnard | Dentist | 4090 Westown Pkwy Ste B1, West Des Moines, IA 50266 | 2013-04-30 |
1962745471 | Samuel Christensen | Dentist | 2575 N Ankeny Blvd Ste 205, Ankeny, IA 50023-4710 | 2013-04-03 |
1477818326 | Julie Ann Smith | Dentist | 800 E 1st St Ste 2800, Ankeny, IA 50021-2077 | 2012-07-06 |
1043507890 | Molly Bremen | Dentist | 7600 Fleur Dr, Des Moines, IA 50321-3111 | 2011-06-30 |
1154557197 | Rachael Anne Revell | Dentist | 5950 Village View Dr, Suite 200, West Des Moines, IA 50266-3844 | 2009-06-04 |
Find all providers with the same taxonomy |
City | CEDAR RAPIDS |
Zip Code | 52404 |
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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.