Provider Demographics
NPI:1942307756
Name:PARRISH, DARLENE RENEA (DMD)
Entity type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:RENEA
Last Name:PARRISH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 E. UNIVERSITY AVENUE STE 302
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316
Mailing Address - Country:US
Mailing Address - Phone:515-264-9022
Mailing Address - Fax:
Practice Address - Street 1:1345 E. UNIVERSITY AVENUE STE 302
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316
Practice Address - Country:US
Practice Address - Phone:515-264-9022
Practice Address - Fax:515-264-9011
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN199641223D0001X
GA110331223G0001X
IADDS-102711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006551100Medicaid
GA00472216AMedicaid