Healthcare Provider Details

I. General information

NPI: 1184383804
Provider Name (Legal Business Name): BUNION SURGERY SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 04/10/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NW 36TH ST. SUITE 100
ANKENY IA
50023
US

IV. Provider business mailing address

5713 NE SHERMAN CT
ANKENY IA
50021-1225
US

V. Phone/Fax

Practice location:
  • Phone: 515-639-3775
  • Fax:
Mailing address:
  • Phone: 515-574-9989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. MINDI JO DAYTON
Title or Position: COO
Credential: DPM
Phone: 515-639-3775