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PEDIATRIC DENTRISTRY OF CORALVILLE INC
NPI 1003823113
Dentist - Pediatric Dentistry in Coralville, IA

Active since August 02, 2006
414 10TH AVE, STE B, CORALVILLE, IA 52241(319) 338-7520(319) 351-5730 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pediatric Dentristry Of Coralville Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC DENTRISTRY OF CORALVILLE INC (NPI 1003823113) is a healthcare organization registered as a pediatric dentistry in Coralville, Iowa and active in the NPI registry since August 2006. The organization lists Polly Iben, Owner, as its authorized official.

NPPES Registry Identity

NPI1003823113
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePEDIATRIC DENTRISTRY OF CORALVILLE INC
Location Address414 10TH AVE, STE BCoralville, IA 52241
Mailing Address414 10th Ave, Ste BCoralville, IA 52241 · (319) 338-7520 · Fax (319) 351-5730
Phone(319) 338-7520
Fax(319) 351-5730
Organization SubpartNo
Authorized OfficialPolly IbenOwner · (319) 338-7520
Enumeration DateAugust 2, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1003823113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in IA · 07894
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
414 10TH AVE, Coralville, IA 52241
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Other Identifiers 1

Medicaid2188144IA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEAN ESTELLE TREDER D.D.S., M.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
414 10TH AVE, SUITE A
CORALVILLE, IA 52241
Johnson County (319) 339-1754

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Dentristry Of Coralville Inc's NPI number?

The NPI number for Pediatric Dentristry Of Coralville Inc is 1003823113. It was assigned to this organization in the NPPES registry on August 2, 2006.

Where is Pediatric Dentristry Of Coralville Inc located?

Pediatric Dentristry Of Coralville Inc is located at 414 10th Ave Ste B, Coralville, IA 52241. The listed phone number is (319) 338-7520.

What is Pediatric Dentristry Of Coralville Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Pediatric Dentristry Of Coralville Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.