EASTERN IOWA ORTHODONTICS (NPI# 1982781340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982781340 |
| Entity Type | Organization |
| Organization Name | EASTERN IOWA ORTHODONTICS |
| Other Organization Name | KADAVY ORTHODONTICS |
| Practice Address |
314 3rd Ave S Clinton IA 52732-4436 |
| Practice Telephone | 5632436622 |
| Practice Fax Number | 5632421484 |
| Mailing Telephone | 5632436622 |
| Mailing Fax Number | 5632421484 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-03-05 |
| Authorized Official Name | JENNIFER TUCKER (OFFICE MANAGER) |
| Authorized Official Telephone | 5632436622 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
07343 | IA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0074542 | 05 |
| Other Name | Type Code |
|---|---|
| Kadavy Orthodontics | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | EASTERN IOWA ORTHODONTICS, PLLC | 220 N Main St Ste 600, Davenport, IA 52801 |
| Street Address |
314 3RD AVE S |
| City | CLINTON |
| State | IA |
| Zip Code | 52732-4436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451523 | Brandon Winter | Dentist | 314 3rd Ave S, Clinton, IA 52732-4436 | 2020-06-11 |
| 1518017722 | Lee Ann Lenz | Dentist | 314 3rd Ave S, Clinton, IA 52732 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343240 | Janet R Graf | Technician | 450 South 19th St., Clinton, IA 52732 | 2019-08-29 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1053835256 | Linda Karina Garcia | Physician Assistant | 1410 N Fourth St, Clinton, IA 52732 | 2017-07-29 |
| 1821528423 | Tricia Lee Grimes | Technician | 2349 Dunham St, Clinton, IA 52732 | 2017-06-15 |
| 1750822425 | Danielle Judd | Skilled Nursing Facility | 2220 N 5th St, Clinton, IA 52732 | 2017-03-15 |
| 1689047185 | Connell Family Chiropractic Pllc | Chiropractor | 1485 Main Avenue, Clinton, IA 52732 | 2015-11-05 |
| 1942619713 | Reese Raymond Petersen | Chiropractor | 2319 S 19th St, Clinton, IA 52732 | 2014-08-06 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1275829921 | Rebecca Plante | Pharmacist | 1309 N 2nd Street, Clinton, IA 52732 | 2011-06-21 |
| 1639318363 | Ryan P Connell | Chiropractor | 1437 Main Ave, Clinton, IA 52732 | 2009-02-19 |
| Find all providers in zip 52732 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558645580 | Tram Ngoc Nguyen | Dentist | 6306 Kirby Rd, Clinton, MD 20735-1336 | 2011-10-10 |
| 1285835991 | Dr. Darrell Adrian Clark D.d.s. | Dentist | 8839 Branch Ave, Clinton, MD 20735-2632 | 2007-05-30 |
| 1356491666 | John C. Pryse,jr. | Dentist | 180 Edgewood Ave, Clinton, TN 37716-2817 | 2007-01-11 |
| 1548328370 | Kenneth Spencer Carlough | Dentist | 248 E Main St, Clinton, CT 06413-2230 | 2006-12-05 |
| 1033282306 | Child & Adult Orthodontics PC | Dentist | 248 East Main St, Clinton, CT 06413 | 2006-11-16 |
| 1174619712 | Sandy E Rushing | Dentist | 749 Clinton Parkway, Clinton, MS 39056 | 2006-10-04 |
| 1659462885 | S Everett Rushing, Dmd,pa | Dentist | 749 Clinton Pkwy, Clinton, MS 39056-5245 | 2006-09-26 |
| 1235510199 | Robert Geiman | Dentist | 248 E Main St, Clinton, CT 06413-2230 | 2015-06-16 |
| 1477790699 | Richard P Johnsen | Dentist | Highway 31, Walnut Pond Professional Building, Clinton, NJ 08809 | 2009-01-09 |
| 1881722288 | David William Schrody | Dentist | 2635 Lincoln Way, Suite E, Clinton, IA 52732-7203 | 2007-02-28 |
| Find all providers in CLINTON | ||||
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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.