Provider Demographics
NPI:1881891778
Name:ZIMMERMAN, KIMBERLY RAE (DDS)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:RAE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 JEFFREY ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4326
Mailing Address - Country:US
Mailing Address - Phone:319-400-3335
Mailing Address - Fax:
Practice Address - Street 1:2211 10TH ST
Practice Address - Street 2:
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536-2461
Practice Address - Country:US
Practice Address - Phone:319-400-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice