Healthcare Provider Details

I. General information

NPI: 1598674244
Provider Name (Legal Business Name): EWALUH HOLDINGS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S 3RD ST STE 2A
POLK CITY IA
50226-1181
US

IV. Provider business mailing address

2518 160TH ST
VAN METER IA
50261-8563
US

V. Phone/Fax

Practice location:
  • Phone: 515-984-6001
  • Fax:
Mailing address:
  • Phone: 319-321-8399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: RYAN HUSSONG
Title or Position: OWNER
Credential: DDS
Phone: 319-321-8399