Healthcare Provider Details

I. General information

NPI: 1891228342
Provider Name (Legal Business Name): JORGE RICARDO SWETT TAPIA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 4TH AVE SE
CEDAR RAPIDS IA
52403-4085
US

IV. Provider business mailing address

1210 4TH AVE SE
CEDAR RAPIDS IA
52403-4085
US

V. Phone/Fax

Practice location:
  • Phone: 319-730-7300
  • Fax: 319-730-7368
Mailing address:
  • Phone: 319-730-7300
  • Fax: 319-730-7368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS-09971
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: