MEDICARE: GOOD SUNDAY, LLC DBA BLANC DENTAL AESTHETICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1689533895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD SUNDAY, LLC DBA BLANC DENTAL AESTHETICS

Provider Business Mailing Address
First Line	:	4212 SW 33RD ST
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50321-2703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6420 COACHLIGHT DR STE 400
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-2881
Country	:	US
Telephone Number	:	773-744-8321
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN A PATRICK
Credential	:	DDS
Telephone Number	:	773-744-8321

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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