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EASTERN IOWA ORAL AND MAXILLOFACIAL SURGERY NPI 1992962732


NPI Information

NPI: 1992962732
Provider Name: EASTERN IOWA ORAL AND MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
4150 EDGEWOOD ROAD NE
SUITE 100
CEDAR RAPIDS, IA
ZIP 52402
Phone: (319) 366-8277
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EASTERN IOWA ORAL AND MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Cedar Rapids, IA. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. EASTERN IOWA ORAL AND MAXILLOFACIAL SURGERY NPI is 1992962732. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4150 EDGEWOOD ROAD NE
SUITE 100
CEDAR RAPIDS, IA
ZIP 52402-609
Phone: (319) 366-8277
Fax: (319) 366-7091

The provider's authorized official is Suzanne J. Stewart .
The authorized official title is Office Manager and has the following contact phone number (319) 366-8277.

The enumeration date for this NPI number is 5/20/2008 and was last updated on 12/28/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery08986IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
108986OTHERIOWABENJAMIN L. FULLER LICENSE NUMBER
21265727150OTHERIOWAJAROM E. MAURER NPI
309173OTHERIOWAJAROM E. MAURER LICENSE NUMBER
41689802910OTHERIOWABENJAMIN L. FULLER NPI

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: 11/14/2023

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