POTLATCH FAMILY DENTAL, PC (NPI# 1245515832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245515832 |
| Entity Type | Organization |
| Organization Name | POTLATCH FAMILY DENTAL, PC |
| Practice Address |
225 6th Street Potlatch ID 83855 |
| Mailing Address |
Po Box 601 Potlatch ID 83855-0601 |
| Practice Telephone | 2088750441 |
| Practice Fax Number | 2088750972 |
| Mailing Telephone | 2088750441 |
| Mailing Fax Number | 2088750972 |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2011-10-15 |
| Authorized Official Name | DR. AMMON MICHAEL PITT (DENTIST) |
| Authorized Official Telephone | 2088750441 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D3984 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8075010 | 05 |
| Street Address |
225 6TH STREET |
| City | POTLATCH |
| State | ID |
| Zip Code | 83855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669866612 | Dan Lawson Dds, PC | Dentist | 225 6th Street, Potlatch, ID 83855 | 2015-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043854508 | Allison Lea Zimms | Massage Therapist | 635 Larch Street, Potlatch, ID 83855 | 2019-10-28 |
| 1558817494 | Suzanne Paul | Family Medicine | 325 Larch Street, Potlatch, ID 83855 | 2016-08-31 |
| 1053504829 | Potlatch Rural Fire Dist | Ambulance | 512 Pine Street, Potlatch, ID 83855 | 2007-08-24 |
| 1285776112 | County of Latah 285 School District | Local Education Agency (LEA) | 136th Street, Potlatch, ID 83855 | 2007-02-14 |
| 1962573444 | Michael S. Hess | Pharmacist | 525 Pine St, Potlatch, ID 83855 | 2006-11-13 |
| 1356438816 | Gritman Medical Center Inc | Clinic/Center | 156 6th St, Potlatch, ID 83855 | 2006-10-06 |
| 1689661050 | Charlotte S Ainge | Physician Assistant | 156 N. 6th St, Potlatch, ID 83855 | 2005-09-30 |
| 1982955779 | Jennifer L Davis | Physician Assistant | 225 6th St, Potlatch, ID 83855 | 2012-09-20 |
| 1992091722 | Skyler S Worthington | Physician Assistant | 156 6th St, Potlatch, ID 83855 | 2011-06-20 |
| 1407410517 | Nicholas John Browneller | Specialist | 610 Oak St, Potlatch, ID 83855-0359 | 2019-04-24 |
| Find all providers in zip 83855 | ||||
| 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 |
|---|---|---|---|---|
| 1891304556 | Birchwood Dental, Pllc | Dentist | 3325 N Ten Mile Rd Ste 140, Meridian, ID 83646-6951 | 2020-07-29 |
| 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 |
| 1740835248 | Braden Comstock | Dentist | 2329 N Merritt Creek Loop, Coeur D Alene, ID 83814-4950 | 2019-08-02 |
| 1902450430 | Jaren M Thueson | Dentist | 106 E 1st N, Rexburg, ID 83440-1614 | 2019-08-01 |
| 1528610359 | Melissa Marie Pysnak | Dentist | 8850 W Emerald St Ste 150, Boise, ID 83704-4809 | 2019-07-11 |
| 1811555758 | Daniel Whitesitt | Dentist | 14596 Id-41, Rathdrum, ID 83858 | 2019-06-05 |
| 1104483122 | Meghan Cyrena Bristlin | Dentist | 3326 4th St Ste 3, Lewiston, ID 83501-4455 | 2019-05-24 |
| 1124684584 | Trevor Tafoya Dds Victory Dental, Pllc | Dentist | 7421 W Victory Rd, Boise, ID 83709-5106 | 2019-05-11 |
| Find all providers with the same taxonomy | ||||
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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.