Provider Demographics
NPI:1902810138
Name:KOURI, LONA MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:LONA
Middle Name:MARIA
Last Name:KOURI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LONA
Other - Middle Name:MARIA
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:15915 MONROE CT
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-1639
Mailing Address - Country:US
Mailing Address - Phone:515-991-6291
Mailing Address - Fax:
Practice Address - Street 1:2423 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-2150
Practice Address - Country:US
Practice Address - Phone:515-276-8572
Practice Address - Fax:515-334-7274
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA22249OtherBCBS