ROBERT O STEVENS DMD, PA (NPI# 1336220144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336220144 |
| Entity Type | Organization |
| Organization Name | ROBERT O STEVENS DMD, PA |
| Other Organization Name | BETHEL DENTAL GROUP |
| Practice Address |
10572 W Business Park Ln Boise ID 83709-6797 |
| Practice Telephone | 2083755656 |
| Practice Fax Number | 2083755928 |
| Mailing Telephone | 2083755656 |
| Mailing Fax Number | 2083755928 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-05-13 |
| Authorized Official Name | DR. ROBERT ORLO STEVENS (DENTIST OWNER) |
| Authorized Official Telephone | 2083755656 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D1807 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS | 64709 | 01 |
| ID | REGENCE BLUE SHIELD | 43162 | 01 |
| Other Name | Type Code |
|---|---|
| Bethel Dental Group | Former Legal Business Name - Organization |
| Street Address |
10572 W BUSINESS PARK LN |
| City | BOISE |
| State | ID |
| Zip Code | 83709-6797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730669292 | Yoeli Park, Pllc | Clinic/Center | 10572 W Business Park Ln, Boise, ID 83709-6797 | 2018-08-15 |
| 1659717916 | Robert Orlo Stevens | Dentist | 10572 W Business Park Ln, Boise, ID 83709-6797 | 2013-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655398 | Jayme Rossow | Occupational Therapist | 101 S. Allumbaugh Way, Boise, ID 83709 | 2020-10-05 |
| 1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
| 1164080164 | Elena Stamm | Audiologist | 10000 W Amity Rd, Boise, ID 83709 | 2019-06-04 |
| 1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
| 1457879975 | Mark Aaron Phelan | Registered Nurse | 779 S. Tennyson Way, Boise, ID 83709 | 2017-09-05 |
| 1235665290 | Sharon Nelson | Dietitian, Registered | 2790 S Goshen Way, Boise, ID 83709 | 2017-05-11 |
| 1982139622 | First Choice Healthcare, Inc. | Home Health | 12400 W. Overland Rd., Ste 100, Boise, ID 83709 | 2017-05-01 |
| 1801320254 | Deborah Carson | Social Worker | 8349 West Harmonica Way, Boise, ID 83709 | 2017-04-12 |
| 1114479862 | Allyson Anne Bates | Nurse Practitioner | 10583 W Lake Hazel Road, Samg Family Medicine, Boise, ID 83709 | 2016-10-28 |
| 1508221391 | Elisha L. Garrison | Counselor | 9196 W. Barnes Street, Boise, ID 83709 | 2015-12-21 |
| Find all providers in zip 83709 | ||||
| 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 |
| 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 |
| 1497317788 | Hidden Springs Dental | Clinic/Center | 5833 W Hidden Springs Dr, Boise, ID 83714-9453 | 2019-07-08 |
| 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.