INDIANOLA PEDIATRIC DENTISTRY (NPI# 1538719075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538719075 |
| Entity Type | Organization |
| Organization Name | INDIANOLA PEDIATRIC DENTISTRY |
| Practice Address |
2001 N 6th St Indianola IA 50125-4873 |
| Practice Telephone | 3192830284 |
| Mailing Telephone | 5158087000 |
| Mailing Fax Number | 5158087001 |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-01-12 |
| Authorized Official Name | DR. SANDRA FOX (OWNER) |
| Authorized Official Telephone | 5158087000 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | INDIANOLA PEDIATRIC DENTISTRY, P.C. | 2001 N 6th St, Indianola, IA 50125 |
| Street Address |
2001 N 6TH ST |
| City | INDIANOLA |
| State | IA |
| Zip Code | 50125-4873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952666307 | Sandra Renae Fox | Dentist | 2001 N 6th St, Indianola, IA 50125-4873 | 2012-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316583107 | Mach3 Physical Therapy and Wellness | Clinic/Center | 938 East Hillcrest Ave, Suite A, Indianola, IA 50125 | 2019-11-27 |
| 1023667995 | Bonnie Dufault | Technician | 2402 West Euclid Ave, Indiana, IA 50125 | 2019-09-04 |
| 1407307499 | Traci Rudolf-hanrahan | Social Worker | 310 North Buxton Street, Indianola, IA 50125 | 2016-10-14 |
| 1548544216 | Long Term Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 126 N Howard St, Suite 102, Indianola, IA 50125 | 2011-09-29 |
| 1629272836 | Michael James Hadden | Specialist/Technologist | Simpson College, 701 North C Street, Indianola, IA 50125 | 2007-06-12 |
| 1245440221 | Indianola Ia Assisted Living | Assisted Living Facility | 608 South 15th St., Indianola, IA 50125 | 2007-05-22 |
| 1689769432 | Michele Tingle | Emergency Medicine | 9128 87th Ln, Indianola, IA 50125 | 2006-10-04 |
| 1538114764 | Sue Marie Peterson | Specialist/Technologist | 1507 N 1st St, Indianola, IA 50125 | 2006-05-24 |
| 1124079934 | Jonathan P Anderson | Optometrist | 225 W Ashland, Ste 1, Indianola, IA 50125 | 2006-05-15 |
| 1528025533 | Jessica A Espenmiller | Occupational Therapist | 1507 North 1st St, Indianola, IA 50125 | 2006-04-26 |
| Find all providers in zip 50125 | ||||
| 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 |
|---|---|---|---|---|
| 1952666307 | Sandra Renae Fox | Dentist | 2001 N 6th St, Indianola, IA 50125-4873 | 2012-07-11 |
| 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 |
| 1245656800 | Iowa Pediatric Dental Center II LLC | Dentist | 5350 Kirkwood Blvd Sw, Suite 700, Cedar Rapids, IA 52404-5233 | 2014-03-06 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.