RIVERSIDE DENTAL PC (NPI# 1053321885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053321885 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE DENTAL PC |
| Practice Address |
1120 Parkway Dr Blackfoot ID 83221 |
| Practice Telephone | 2087850878 |
| Practice Fax Number | 2087850878 |
| Mailing Telephone | 2087850878 |
| Mailing Fax Number | 2087850878 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2008-07-30 |
| Authorized Official Name | DR. BRADFORD WILLIAM HARPER (OWNER/PRESIDENT) |
| Authorized Official Telephone | 2087850878 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D3225 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 518546704002 | 05 | |
| ID | 002801200 | 05 |
| Street Address |
1120 PARKWAY DR |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245560945 | Affordable Family Dentistry PC | Dentist | 1120 Parkway Dr, Blackfoot, ID 83221-1651 | 2010-01-04 |
| 1659507481 | Tracy Dean Jenkins | Dentist | 1120 Parkway Dr, Blackfoot, ID 83221-1651 | 2009-06-08 |
| 1225208655 | Bradford William Harper | Dentist | 1120 Parkway Dr, Blackfoot, ID 83221-1651 | 2008-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548887136 | Bald 1 Sleep Solutions LLC | Dentist | 790 N Meridian St, Blackfoot, ID 83221-4936 | 2020-06-29 |
| 1104038991 | Brent Wilson Harper | Dentist | 694 W. Hwy. 39, Blackfoot, ID 83221 | 2007-05-04 |
| 1194869990 | Charles Gordon Simpson | Dentist | 1180 Parkway Dr, Blackfoot, ID 83221-0869 | 2007-02-16 |
| 1821104910 | Von James Kunz | Dentist | 600 Jensen Grove Drive, Blackfoot, ID 83221 | 2006-08-22 |
| 1700894771 | Richard Russell Burt | Dentist | 310 W Idaho St, Blackfoot, ID 83221-0248 | 2006-08-04 |
| 1205208162 | Family Dental of Blackfoot LLC | Dentist | 2407 Teeples Dr, Blackfoot, ID 83221-5877 | 2015-10-30 |
| 1578958252 | Blackfoot Family Dentistry Pllc | Dentist | 380 W Judicial St, Blackfoot, ID 83221-2122 | 2015-03-31 |
| 1578884235 | Kelly Weaver | Dentist | 310 W Idaho St, Blackfoot, ID 83221-1710 | 2010-06-17 |
| 1831415447 | Paul Lloyd Hansen | Dentist | 625 W Bridge St, Blackfoot, ID 83221-2018 | 2010-04-08 |
| 1588837496 | Damon T. Armstrong D.d.s., P.c | Dentist | 625 W Pacific St, Suite #4, Blackfoot, ID 83221-2034 | 2008-04-11 |
| Find all providers in BLACKFOOT | ||||
Please comment or provide details below to improve the information on RIVERSIDE DENTAL PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.