Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SHADOW CREEK PEDIATRIC DENTISTRY OF WAUKEE LLC
NPI 1417867946
Dentist - Pediatric Dentistry in Waukee, IA

Q: What is Shadow Creek Pediatric Dentistry Of Waukee LLC's specialty?

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

Active since September 08, 2026

822 NE ALICES RD, WAUKEE, IA 50263(515) 264-2772 Get Directions Write a Review

NPPES record added: September 8, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

On this page

About Shadow Creek Pediatric Dentistry Of Waukee Llc NPPES

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

SHADOW CREEK PEDIATRIC DENTISTRY OF WAUKEE LLC (NPI 1417867946) is a healthcare organization registered as a pediatric dentistry in Waukee, Iowa and active in the NPI registry since September 2026. The organization lists Lucas Bland, Coo, as its authorized official.

NPPES Registry Identity

NPI1417867946

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameSHADOW CREEK PEDIATRIC DENTISTRY OF WAUKEE LLC

Location Address822 NE ALICES RDWaukee, IA 50263-8857

Mailing Address822 Ne Alices RdWaukee, IA 50263-8857 · (515) 264-2772

Phone(515) 264-2772

Organization SubpartNo

Authorized OfficialLucas BlandCoo · (515) 577-6367

Enumeration DateSeptember 8, 2026

NPPES CertifiedSeptember 8, 2026

✔ NPI 1417867946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

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.

822 NE ALICES RD, Waukee, IA 50263

Open in Google Maps ↗

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 2

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

NANCY I HAMMOND DDS MS

Dentist (Pediatric Dentistry)

822 NE ALICES RD
WAUKEE, IA 50263

Dallas County (515) 264-2772

SHADOW CREEK PEDIATRIC DENTISTRY, LLC

Clinic/Center (Dental)

822 NE ALICES RD
WAUKEE, IA 50263

Dallas County (515) 264-2772

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 Shadow Creek Pediatric Dentistry Of Waukee LLC's NPI number?

The NPI number for Shadow Creek Pediatric Dentistry Of Waukee LLC is 1417867946. It was assigned to this organization in the NPPES registry on September 8, 2026.

Where is Shadow Creek Pediatric Dentistry Of Waukee LLC located?

Shadow Creek Pediatric Dentistry Of Waukee LLC is located at 822 NE Alices Rd, Waukee, IA 50263. The listed phone number is (515) 264-2772.

What is Shadow Creek Pediatric Dentistry Of Waukee LLC'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 Shadow Creek Pediatric Dentistry Of Waukee LLC was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.