ADVANCED PERIODONTICS CENTER NPI 1578095097

NPI Information

  • NPI: 1578095097
  • Provider Name: ADVANCED PERIODONTICS CENTER
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • CLIA Number: 16D2068702
  • Address: 320 MCKENZIE AVE
    SUITE 207
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Phone: (712) 435-0992

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NPI Details

ADVANCED PERIODONTICS CENTER is a periodontics dentist in Council Bluffs, IA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. ADVANCED PERIODONTICS CENTER NPI is 1578095097. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

320 MCKENZIE AVE
SUITE 207
COUNCIL BLUFFS, IA
ZIP 51503-002
Phone: (712) 435-0992
Fax: (402) 552-2330

The provider's authorized official is Sima Zitouni .
The authorized official title is Periodontist and has the following contact phone number (402) 651-9341.

The CLIA number assigned to this NPI record is 16D2068702 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/3/2017 and was last updated on 4/3/2017.

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
11223P0300XDentistPeriodonticsIOWAYes

What is NPI?

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

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