Provider Demographics
NPI:1316926785
Name:DENNIS-SMITHART, RONDA KIM (MD,FAAP)
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:KIM
Last Name:DENNIS-SMITHART
Suffix:
Gender:F
Credentials:MD,FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:641-682-8145
Mailing Address - Fax:641-682-8857
Practice Address - Street 1:123 E 3RD ST STE 2
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2937
Practice Address - Country:US
Practice Address - Phone:641-682-8145
Practice Address - Fax:641-682-8857
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA35250OtherWELLMARK
IA24808OtherSTATE LICENSE #
IA3036301Medicaid
IA3036301Medicaid
IAI12458Medicare ID - Type Unspecified