Provider Demographics
NPI:1558433037
Name:EMGE, JOSEPH PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:EMGE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAPLE ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601
Mailing Address - Country:US
Mailing Address - Phone:712-240-4231
Mailing Address - Fax:712-246-4231
Practice Address - Street 1:301 MAPLE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601
Practice Address - Country:US
Practice Address - Phone:712-240-4231
Practice Address - Fax:712-246-4231
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5119IA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0035709Medicaid