Provider Demographics
NPI:1942363411
Name:DENTISTRY AT SOMERSET, LLP
Entity Type:Organization
Organization Name:DENTISTRY AT SOMERSET, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST AND PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:NIEGSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:515-268-0516
Mailing Address - Street 1:2720 STANGE ROAD
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010
Mailing Address - Country:US
Mailing Address - Phone:515-126-8051
Mailing Address - Fax:515-268-9161
Practice Address - Street 1:2720 STANGE RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3974
Practice Address - Country:US
Practice Address - Phone:515-126-8051
Practice Address - Fax:515-268-9161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA07994302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization