1689898603 NPI number — DENTISTRY UNLIMITED 1 PLC

Table of content: (NPI 1689898603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689898603 NPI number — DENTISTRY UNLIMITED 1 PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENTISTRY UNLIMITED 1 PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689898603
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3520 UTICA RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETTENDORF
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52722-1620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-359-9165
Provider Business Mailing Address Fax Number:
563-359-1824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3520 UTICA RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETTENDORF
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52722-1620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-359-9165
Provider Business Practice Location Address Fax Number:
563-359-1824
Provider Enumeration Date:
04/12/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHEELER
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
563-359-9165

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  6110 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223G0001X , with the licence number: 6313 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223G0001X , with the licence number: 7473 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223G0001X , with the licence number: 08354 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223P0221X , with the licence number: 7498 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223P0221X , with the licence number: 7854 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)