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NPI Code Detail

MEDICARE: DENTISTRY AT SOMERSET, LLP

MEDICARE: DENTISTRY AT SOMERSET, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance Organization07994IA

General Provider Information

NPI Number : 1942363411
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTISTRY AT SOMERSET, LLP
Provider Business Mailing Address
First Line : 2720 STANGE ROAD
Second Line :
City : AMES
State : IA
Zip : 50010
Country : US
Telephone Number : 515-126-8051
Fax Number : 515-268-9161
Provider Business Practice Location Address
First Line : 2720 STANGE RD
Second Line :
City : AMES
State : IA
Zip : 50010-3974
Country : US
Telephone Number : 515-126-8051
Fax Number : 515-268-9161
Authorized Official
Title or Position : DENTIST AND PARTNER
Name : DR. JASON PATRICK NIEGSCH
Credential : D.D.S.
Telephone Number : 515-268-0516
Provider Enumeration Date : 12/18/2006
Last Update Date : 08/22/2020

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Directions to “DENTISTRY AT SOMERSET, LLP ” Practice Location

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