Provider Demographics
NPI:1508571555
Name:BUNION SURGERY SPECIALISTS LLC
Entity Type:Organization
Organization Name:BUNION SURGERY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINDI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:DAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-639-2775
Mailing Address - Street 1:3720 N ANKENY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4619
Mailing Address - Country:US
Mailing Address - Phone:515-639-3775
Mailing Address - Fax:
Practice Address - Street 1:4214 FLEUR DR STE 7
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-2300
Practice Address - Country:US
Practice Address - Phone:515-244-0633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty