BRDA PLLC NPI 1144617721

NPI Information

  • NPI: 1144617721
  • Provider Name: BRDA PLLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Other Name: BLAIR RIDGE DENTAL
  • Address: 1700 BLAIRS FERRY RD
    HIAWATHA, IA
    ZIP 52233
  • Phone: (319) 396-3596

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NPI Details

BRDA PLLC is a dental clinic center in Hiawatha, IA. BRDA PLLC NPI is 1144617721. The provider is registered as an organization entity type.
The provider Other Name Is Blair Ridge Dental.

The provider's business location address is:

1700 BLAIRS FERRY RD
HIAWATHA, IA
ZIP 52233-033
Phone: (319) 396-3596
Fax: (319) 378-0546

The provider's authorized official is Amy N Wilken-heying .
The authorized official title is Owner and has the following contact phone number (319) 396-3596.

The enumeration date for this NPI number is 4/21/2015 and was last updated on 4/21/2015.

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
1261QD0000XClinic/CenterDentalDDS-08160IOWAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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