INTERMOUNTAIN DENTAL SPECIALISTS (NPI# 1134522535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134522535 |
Entity Type | Organization |
Organization Name | INTERMOUNTAIN DENTAL SPECIALISTS |
Practice Address |
12249 W Mcmillan Rd Boise ID 83713-0555 |
Practice Telephone | 2089172855 |
Mailing Telephone | 2089172855 |
Enumeration Date | 2014-09-30 |
Last Update Date | 2014-09-30 |
Authorized Official Name | DR. JERRY MICHAEL CARBONE (MANAGING MEMBER) |
Authorized Official Telephone | 2089172855 |
Authorized Official Credential | D.M.D |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D3642EN | ID | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881069177 | Intermountain Dental Specialists | Dentist | 2797 N Highway 89, Suite 200, Pleasant View, UT 84404-1216 | 2015-12-11 |
Street Address |
12249 W MCMILLAN RD |
City | BOISE |
State | ID |
Zip Code | 83713-0555 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730197690 | Scott Alan Wright | Dentist | 12249 W Mcmillan Rd, Boise, ID 83713-2471 | 2006-08-04 |
1821180944 | Kenyon L Oyler | Dentist | 12249 W Mcmillan Rd, Contenntal Dental Center, Boise, ID 83713-0555 | 2006-09-28 |
1316050628 | Jerry Michael Carbone | Dentist | 12249 W Mcmillan Rd, Boise, ID 83713-0555 | 2006-08-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
Find all providers in zip 83713 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831678903 | Town Square Dental Partners, Pllc | Clinic/Center | 8660 W Emerald St Ste 152, Boise, ID 83704-4828 | 2018-08-09 |
1265935902 | Wilson Dental Pllc | Clinic/Center | 10497 W Garverdale Ct Ste 107, Boise, ID 83704-5468 | 2018-03-08 |
1912356841 | Joseph P. Schmidt Pllc | Clinic/Center | 2600 W Rose Hill St, Suite 100, Boise, ID 83705-5967 | 2016-06-10 |
1487046363 | Boise Caring Dentistry, P.C. | Clinic/Center | 5630 N Eagle Rd, Suite 101, Boise, ID 83713-4901 | 2015-03-02 |
1598154981 | Horizon 1 Pllc | Clinic/Center | 1000 N Curtis Rd Ste 103, Boise, ID 83706-1345 | 2015-01-22 |
1336220144 | Robert O Stevens Dmd, Pa | Clinic/Center | 10572 W Business Park Ln, Boise, ID 83709-6797 | 2006-10-18 |
1902810633 | Community Health Clinics | Clinic/Center | 2301 N 36th St, Suite 102, Boise, ID 83703-5207 | 2006-07-28 |
1255339297 | Dr. Kaci B. Jensen, Pllc | Clinic/Center | 9755 W Leo Dr, Boise, ID 83709-8249 | 2005-07-13 |
1427669720 | Lake Harbor Dental Pllc | Clinic/Center | 5355 W State St, Boise, ID 83703-3333 | 2020-08-11 |
1659915437 | Weimer Dental Pllc | Clinic/Center | 8336 W Northview St, Boise, ID 83704-7132 | 2019-11-04 |
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.