Provider Demographics
NPI:1457326001
Name:PARKS & SCHMIT ORTHODONTICS
Entity Type:Organization
Organization Name:PARKS & SCHMIT ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:319-363-3575
Mailing Address - Street 1:2727 1ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-4844
Mailing Address - Country:US
Mailing Address - Phone:319-363-3575
Mailing Address - Fax:319-363-8886
Practice Address - Street 1:2727 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4844
Practice Address - Country:US
Practice Address - Phone:319-363-3575
Practice Address - Fax:319-363-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA008823OtherDELTA PROVIDER#
IA0088237Medicaid
IA38292OtherBC/BS OF IA GRP PROV#