Tieszen, Dennis D
Tieszen, Dennis D is an individual health care provider with primary practice located at 999 Home Plz Suite 100, Waterloo IA 50701-4822. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Tieszen, Dennis D can be contacted via phone (319) 236-0815.Contact Information
Primary practice address
999 Home Plz Suite 100
Waterloo IA 50701-4822
Phone: (319) 236-0815
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 01790 | Iowa |
Profile Details
| NPI number | 1952452831 |
|---|---|
| LBN Legal business name | Tieszen, Dennis D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Dec 22nd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952452831 | NPPES |
| Iowa | MEDICAID | 0117267 | |
| Iowa | Other | 18418 | |
| Iowa | Other | 410030429 | |
| Iowa | Other | CG4244 |
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