Healthcare Provider Details

I. General information

NPI: 1457280356
Provider Name (Legal Business Name): GREATER DES MOINES ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E HICKMAN RD
WAUKEE IA
50263-5011
US

IV. Provider business mailing address

3751 SW INDIGO AVE
WEST DES MOINES IA
50266-5363
US

V. Phone/Fax

Practice location:
  • Phone: 515-729-4653
  • Fax:
Mailing address:
  • Phone: 515-729-4653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AUSTIN PRESCOTT FOSTER
Title or Position: OWNER
Credential: DDS, MS
Phone: 515-729-4653