Provider Demographics
NPI:1033799093
Name:WEST FIRST DENTAL
Entity Type:Organization
Organization Name:WEST FIRST DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SATYA VIJAY KUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VADDADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:563-258-2186
Mailing Address - Street 1:1421 W 1ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2115
Mailing Address - Country:US
Mailing Address - Phone:319-483-6444
Mailing Address - Fax:319-694-6111
Practice Address - Street 1:1421 W 1ST ST STE B
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2115
Practice Address - Country:US
Practice Address - Phone:319-483-6444
Practice Address - Fax:319-694-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1588895262Medicaid