Healthcare Provider Details

I. General information

NPI: 1205769650
Provider Name (Legal Business Name): BENNETT IVAN ZUCK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1049
US

IV. Provider business mailing address

51300 POMERANTZ FAMILY PAVILION
IOWA CITY IA
52242-1049
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-2205
  • Fax: 319-353-6923
Mailing address:
  • Phone: 319-356-2205
  • Fax: 319-353-6923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDDS-10472
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: