IDAHO DENTAL ANESTHESIA PLLC (NPI# 1629470141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629470141 |
| Entity Type | Organization |
| Organization Name | IDAHO DENTAL ANESTHESIA PLLC |
| Practice Address |
37 W Archerfield St Ste 100 Meridian ID 83646-6587 |
| Practice Telephone | 2083912894 |
| Mailing Telephone | 2083912894 |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | DR. RYAN W JUDD (DENTIST ANESTHESIOLOGIST) |
| Authorized Official Telephone | 5036799797 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
D-4613 | ID | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 317 S River St, Hailey, ID 833338426 | 5036799797 | |
| 1411 Falls Ave E Ste 1000c, Twin Falls, ID 833013459 | 5036799797 | |
| 1619 N Whitley Dr, Fruitland, ID 836192162 | 5036799797 | |
| 1311 E Central Dr, Meridian, ID 836427991 | 5036799797 | |
| 1186 Eastland Dr N, Twin Falls, ID 833018973 | 5036799797 | |
| 1550 E Heritage Park St, Meridian, ID 836466439 | 5036799797 | |
| 136 E Mallard Dr, Boise, ID 837063975 | 5036799797 | |
| 478 Sw 12th St, Ontario, OR 979143202 | 5036799797 | |
| 12190 W Evely Pines Ln, Star, ID 836696126 | 5036799797 | |
| 1408 Pomerelle Ave Ste D, Burley, ID 833182068 | 5036799797 |
| Street Address |
37 W ARCHERFIELD ST STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83646-6587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659546174 | Randall Parley Blair | Dentist | 37 W Archerfield St Ste 100, Meridian, ID 83646-6587 | 2008-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1356977466 | Tanabell Health Services Inc | Assisted Living Facility | 2584 E Magic View Dr, Meridian, ID 83646 | 2020-03-20 |
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1639644107 | Joseph Anomalay | Counselor | 6700 N. Linder Rd, Ste 156 #257, Meridian, ID 83646 | 2018-10-10 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1134511264 | Brittany Laub | Massage Therapist | 2572 N Stokesberry Pl #300, Meridian, ID 83646 | 2015-02-26 |
| 1194117366 | Westfall Ventures, Inc | Health Maintenance Organization | 2572 N. Stokesberry Pl, Meridian, ID 83646 | 2015-02-25 |
| Find all providers in zip 83646 | ||||
| Taxonomy Code | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609946078 | Ryan W Judd | Dentist | 5360 N Eagle Rd, Boise, ID 83713-4901 | 2006-11-09 |
Please comment or provide details below to improve the information on IDAHO DENTAL ANESTHESIA PLLC.
| 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.