Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 122300000X | Dentist | | DDS-09406 | IOWA | No |
| 2 | 1223D0001X | Dentist | Dental Public Health | DDS-09406 | IOWA | No |
| 3 | 1223E0200X | Dentist | Endodontics | DDS-09406 | IOWA | No |
| 4 | 1223G0001X | Dentist | General Practice | DDS-09406 | IOWA | No |
| 5 | 1223P0106X | Dentist | Oral and Maxillofacial Pathology | DDS-09406 | IOWA | No |
| 6 | 1223P0221X | Dentist | Pediatric Dentistry | DDS-09406 | IOWA | No |
| 7 | 1223P0300X | Dentist | Periodontics | DDS-09406 | IOWA | No |
| 8 | 1223P0700X | Dentist | Prosthodontics | DDS-09406 | IOWA | No |
| 9 | 1223S0112X | Dentist | Oral and Maxillofacial Surgery | DDS-09406 | IOWA | No |
| 10 | 1223X0008X | Dentist | Oral and Maxillofacial Radiology | DDS-09406 | IOWA | No |
| 11 | 1223X0400X | Dentist | Orthodontics and Dentofacial Orthopedics | DDS-09406 | IOWA | No |
| 12 | 390200000X | Student in an Organized Health Care Education/Training Program | | DDS-09406 | IOWA | Yes |
