DR. C JAMES MIKELSON (NPI# 1831101427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831101427 |
| Entity Type | Individual |
| Full Name | DR. C JAMES MIKELSON |
| Credential | DDS |
| Practice Address |
3308 Kimball Ave Waterloo IA 50702 |
| Practice Telephone | 3192336177 |
| Practice Fax Number | 3192343906 |
| Mailing Telephone | 3192336177 |
| Mailing Fax Number | 3192343906 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
05851 | IA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0120865 | 05 |
| Street Address |
3308 KIMBALL AVE |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563303 | Kathleen Jo Bohr | Dentist | 3308 Kimball Ave, Waterloo, IA 50702-5758 | 2019-08-13 |
| 1235390295 | Benjamin Robert Squires | Dentist | 3308 Kimball Ave, Waterloo, IA 50702-5758 | 2008-06-23 |
| 1235306408 | James J. Cahill, D.d.s., P.C. | Dentist | 3308 Kimball Ave, Waterloo, IA 50702-5758 | 2008-05-15 |
| 1740327154 | James J Cahill | Dentist | 3308 Kimball Ave, Waterloo, IA 50702-5758 | 2007-02-01 |
| 1821141581 | Craig Warren Driver | Dentist | 3308 Kimball Ave, Waterloo, IA 50702-5758 | 2007-01-18 |
| 1356455448 | John Kent Spragg | Dentist | 3308 Kimball Ave, Waterloo, IA 50702-5758 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| 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 |
|---|---|---|---|---|
| 1659753069 | Hannah Rose Leuschen | Dentist | 4015 Hurst Dr, Waterloo, IA 50701-9035 | 2015-06-22 |
| 1437571320 | Waterloo Family Dental | Dentist | 245 N. Monroe Street, Waterloo, WI 53594 | 2014-01-10 |
| 1164773735 | Stephen Frederick Hartman | Dentist | 107 North Virginia Street, Waterloo, NY 13165 | 2012-09-24 |
| 1447400791 | Dr John F Blattner & Dr Dwight D Heberer PC | Dentist | 226 Westview Plaza Dr, Waterloo, IL 62298-1253 | 2008-09-23 |
| 1720236128 | Bradley W Mitchell | Dentist | 413 W 3rd St, Waterloo, IL 62298-1358 | 2008-08-28 |
| 1386808079 | Christopher Glenn Eastman | Dentist | 2765 Crossroads Blvd, Waterloo, IA 50702 | 2008-07-11 |
| 1033237318 | Dr Darryll L Beard Dmd Ltd | Dentist | 208 Bradford Lane, Waterloo, IL 62298 | 2007-03-26 |
| 1043363757 | Martin E. Averill | Dentist | 2102 Kimball Ave, Waterloo, IA 50702-5037 | 2007-01-18 |
| 1487703286 | Larry G Payne | Dentist | 605 S Wayne St, Waterloo, IN 46793-9472 | 2007-01-09 |
| 1689730327 | John Vernon Jetty | Dentist | 86 Center St, Waterloo, NY 13165-1026 | 2006-12-28 |
| Find all providers in WATERLOO | ||||
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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.