Lyle Thomas Roudabush, D.D.S.

General Practice Dentistry · Grinnell, IA

Individual Active NPI

NPI number 1861520652

Practice location

825 Broad St
Grinnell, IA 50112-2153
Phone
(641) 236-6169
Fax
(641) 236-6041

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NPI record

NPI
1861520652
Entity type
Individual (Type 1)
Enumeration date
March 1, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 5719 IA

Mailing address

125 16TH Ave.
Grinnell, IA 50112
Phone
(641) 236-8139
Fax
(641) 236-6041

About Dr. Roudabush

Lyle Thomas Roudabush, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 825 Broad St, Grinnell, IA 50112-2153. The NPI number 1861520652 was assigned on March 1, 2007 and the record was last updated on July 8, 2007.

Dr. Roudabush lists a license in the registry: #5719 (IA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Lyle Thomas Roudabush, D.D.S.?

The NPI number is 1861520652.

What is the phone number of Dr. Roudabush?

The phone number listed for the practice location is (641) 236-6169.

Where is Dr. Roudabush located?

825 Broad St, Grinnell, IA 50112-2153.

What is the taxonomy code for Dr. Roudabush?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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