Healthcare Provider Details

I. General information

NPI: 1346126869
Provider Name (Legal Business Name): CAMILLA MACHADO FEITOSA DE AL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NEWTON RD
IOWA CITY IA
52242-1001
US

IV. Provider business mailing address

322 DENTAL SCIENCE BLDG S
IOWA CITY IA
52242-1001
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-7440
  • Fax: 319-335-7451
Mailing address:
  • Phone: 319-335-7440
  • Fax: 319-335-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberFAC-40249
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: