MR. KENT P ELLERBROEK MD
NPI 1104800192
Dermatology in Waterloo, IA

Active since December 02, 2005
541 KING DR, WATERLOO, IA 50702(319) 235-6323(319) 235-0249 Get Directions Write a Review

NPPES record last updated: October 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kent P Ellerbroek Md NPPES

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

MR. KENT P ELLERBROEK MD (NPI 1104800192) is an individual dermatology provider in Waterloo, Iowa, licensed in Iowa (20213) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1104800192
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameMR. KENT P ELLERBROEKCredential: MD
Location Address541 KING DRWaterloo, IA 50702-5959
Mailing Address541 King DrWaterloo, IA 50702-5959 · (319) 235-6323 · Fax (319) 235-0249
Fax(319) 235-0249
Sole ProprietorYes
Enumeration DateDecember 2, 2005
Last NPPES UpdateOctober 14, 2008
NPI 1104800192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in IA · 20213
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
541 KING DR, Waterloo, IA 50702

Other Identifiers 4

Medicare PIN070010282IA
Medicare PIN169800001IA
Medicare UPINA01563
Medicaid0169805IA

Other Providers at the Same Location NPPES 2

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

Chiropractor
541 KING DR
WATERLOO, IA 50702
Dermatology (MOHS-Micrographic Surgery)
541 KING DR
WATERLOO, IA 50702

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 Kent Ellerbroek's NPI number?

The NPI number for Kent Ellerbroek is 1104800192. It was assigned to this individual provider in the NPPES registry on December 2, 2005.

Where is Kent Ellerbroek located?

Kent Ellerbroek practices at 541 King Dr, Waterloo, IA 50702. The listed phone number is (319) 235-6323.

What is Kent Ellerbroek's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Kent Ellerbroek was last updated on October 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.