Provider Demographics
NPI:1154009744
Name:JAISWAL, DEEPIKA (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:DEEPIKA
Middle Name:
Last Name:JAISWAL
Suffix:
Gender:
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 CORAL CT STE 2
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2872
Mailing Address - Country:US
Mailing Address - Phone:319-337-2599
Mailing Address - Fax:
Practice Address - Street 1:2441 CORAL CT STE 2
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2872
Practice Address - Country:US
Practice Address - Phone:319-337-2599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101471223S0112X, 1223X2210X
IADDS-10147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist