Provider Demographics
NPI:1548358799
Name:STRAUMANIS, JURIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JURIS
Middle Name:
Last Name:STRAUMANIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IA
Mailing Address - Zip Code:52772
Mailing Address - Country:US
Mailing Address - Phone:563-886-2438
Mailing Address - Fax:
Practice Address - Street 1:120 W 5TH ST
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IA
Practice Address - Zip Code:52772
Practice Address - Country:US
Practice Address - Phone:563-886-2438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA54731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0109314Medicaid