MILLENNIUM FAMILY DENTAL - BOISE LLC (NPI# 1104925064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104925064 |
| Entity Type | Organization |
| Organization Name | MILLENNIUM FAMILY DENTAL - BOISE LLC |
| Practice Address |
813 Stilson Rd Suite B Boise ID 83703 |
| Mailing Address |
1848 Millenium Way Meridian ID 83642 |
| Practice Telephone | 2083424644 |
| Practice Fax Number | 2083670283 |
| Mailing Telephone | 2088882026 |
| Mailing Fax Number | 2088882094 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-12-30 |
| Authorized Official Name | JENNIFER LYNN VIQUELIA (OFFICE MANAGER) |
| Authorized Official Telephone | 2088882026 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806766100 | 05 |
| Street Address |
813 STILSON RD SUITE B |
| City | BOISE |
| State | ID |
| Zip Code | 83703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144326695 | George H Lewis | Dentist | 813 Stilson Rd, Suite A, Boise, ID 83703 | 2006-09-15 |
| 1710050943 | Richard E Ferguson | Dentist | 813 Stilson Rd, Suite C, Boise, ID 83703-5119 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588273635 | Atlantis Dental Care, P.a. | Dentist | 13238 W Persimmon Ln Ste 100, Boise, ID 83713-1968 | 2020-07-24 |
| 1235747338 | Dentists of Boise and Orthodontics, PC | Dentist | 7500 W State St Ste 110, Boise, ID 83714-6074 | 2020-07-15 |
| 1346895232 | Tejasi Avasare | Dentist | 8321 W Overland Rd, Boise, ID 83709-1640 | 2019-08-07 |
| 1528610359 | Melissa Marie Pysnak | Dentist | 8850 W Emerald St Ste 150, Boise, ID 83704-4809 | 2019-07-11 |
| 1124684584 | Trevor Tafoya Dds Victory Dental, Pllc | Dentist | 7421 W Victory Rd, Boise, ID 83709-5106 | 2019-05-11 |
| 1982260360 | Brant Burbank | Dentist | 4255 N Eagle Rd Ste 102, Boise, ID 83713-0701 | 2019-05-11 |
| 1972023398 | Northview Dental Partnership LLC | Dentist | 7480 W Northview St, Boise, ID 83704-7232 | 2017-06-27 |
| 1962939421 | Travis Jon Weimer | Dentist | 8336 W Northview St, Boise, ID 83704-7132 | 2017-05-16 |
| 1922480284 | Jonathan W Pluid | Dentist | 4274 N Eagle Rd, Boise, ID 83713-0726 | 2015-06-23 |
| 1922489673 | Gray Team LLC | Dentist | 813 N Stilson Rd, Ste:b, Boise, ID 83703-5119 | 2015-06-17 |
| Find all providers in BOISE | ||||
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| 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.