Healthcare Provider Details

I. General information

NPI: 1942395637
Provider Name (Legal Business Name): DAVID C. GEHRING, DDS, MS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5012 CENTER POINT RD NE
CEDAR RAPIDS IA
52402-2465
US

IV. Provider business mailing address

5012 CENTER POINT RD NE
CEDAR RAPIDS IA
52402-2465
US

V. Phone/Fax

Practice location:
  • Phone: 319-378-3333
  • Fax: 319-378-3332
Mailing address:
  • Phone: 319-378-3333
  • Fax: 319-378-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7644
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1124941
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: DR. DAVID C GEHRING
Title or Position: OWNER
Credential: DDS, MS
Phone: 319-378-3333