Broadlawns Medical Center Dental Clinic
LBN: Broadlawns Medical Center
Broadlawns Medical Center Dental Clinic is an health care organization with primary practice located at 1801 Hickman Rd , Des Moines IA 50314-1505. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty.
Broadlawns Medical Center can be contacted via phone (515) 282-2421, or through Mandracchia, Vincent J via phone (515) 282-2562.
Contact Information
Primary practice address
1801 Hickman Rd
Des Moines IA 50314-1505
Phone: (515) 282-2421
Fax:
Website:
Authorized official contact:
Name: Mandracchia, Vincent J Doctor of Podiatric Medicine (DPM)
Phone: (515) 282-2562
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Dentist | 122300000X | 07724 | Iowa |
Profile Details
NPI number | 1609848878 |
---|---|
LBN Legal business name | Broadlawns Medical Center |
DBA Doing business as | Broadlawns Medical Center Dental Clinic |
Authorized official | Mandracchia, Vincent J Doctor of Podiatric Medicine (DPM) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Feb 2nd, 2006 |
Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1609848878 | NPPES |
Iowa | MEDICAID | 0066068 | |
Iowa | Other | 2601013 | |
Iowa | Other | 20023 | |
Iowa | Other | 6230290 | |
Iowa | Other | A5031401 | |
Iowa | Other | 29705 |
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