Provider Demographics
NPI:1922979277
Name:EASTERN IOWA SEDATION DENTISTRY LLC
Entity type:Organization
Organization Name:EASTERN IOWA SEDATION DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAROD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-321-5034
Mailing Address - Street 1:2023 CEDAR PLAZA DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2392
Mailing Address - Country:US
Mailing Address - Phone:563-607-5979
Mailing Address - Fax:
Practice Address - Street 1:2023 CEDAR PLAZA DR UNIT 2
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2392
Practice Address - Country:US
Practice Address - Phone:563-900-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty