CHILDREN'S DENTISTRY OF IDAHO, PLLC (NPI# 1689942849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689942849 |
Entity Type | Organization |
Organization Name | CHILDREN'S DENTISTRY OF IDAHO, PLLC |
Practice Address |
349 W Iowa Ave Nampa ID 83686-2856 |
Practice Telephone | 2084675100 |
Mailing Telephone | 2084675100 |
Enumeration Date | 2011-12-02 |
Last Update Date | 2011-12-02 |
Authorized Official Name | JEFFREY BRYSON (OWNER/DENTIST) |
Authorized Official Telephone | 2084675100 |
Authorized Official Credential | D.D.S. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D-4399-PD | ID | Dental Providers |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | CHILDREN'S DENTISTRY OF IDAHO, PLLC | 515 W Idaho Ave, Ontario, OR 97914 |
Street Address |
349 W IOWA AVE |
City | NAMPA |
State | ID |
Zip Code | 83686-2856 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316956568 | Kevin A Kizer | Dentist | 349 W Iowa Ave, Nampa, ID 83686-2856 | 2006-08-05 |
1932372026 | Children's Dentistry Pllc | Dentist | 349 W Iowa Ave, Nampa, ID 83686-2856 | 2008-04-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
Find all providers in zip 83686 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
1316956568 | Kevin A Kizer | Dentist | 349 W Iowa Ave, Nampa, ID 83686-2856 | 2006-08-05 |
1932372026 | Children's Dentistry Pllc | Dentist | 349 W Iowa Ave, Nampa, ID 83686-2856 | 2008-04-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124657010 | Rigby Pediatric Dental Pllc | Dentist | 688 Rigby Lake Circle, Suite 4, Rigby, ID 83442 | 2020-04-03 |
1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
1902325749 | Cherry Lane Kids Dentistry | Dentist | 1558 N Crestmont Dr Ste A, Meridian, ID 83642-2194 | 2017-09-13 |
1922462142 | Our Town Family Dentistry | Dentist | 39 W Idaho St, Weiser, ID 83672-1943 | 2016-04-13 |
1720447097 | Brock Coletti | Dentist | 3235 N Towerbridge Way Ste 200, Meridian, ID 83646-5721 | 2016-02-15 |
1154799047 | Smiles 4 Kids Blackfoot Pllc | Dentist | 621 Jensen Grove Dr, Blackfoot, ID 83221-1685 | 2015-09-09 |
1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
1679812002 | Dentistry for Kids Pllc | Dentist | 625 E Alameda Rd., Pocatello, ID 83201 | 2013-02-05 |
1609106012 | Cordell Denton Nebeker | Dentist | 4111 Clocktower Ave., Caldwell, ID 83607 | 2010-01-07 |
1316192370 | A Childs Smile | Dentist | 3299 E. 17th Street, Ammon, ID 83406 | 2008-11-18 |
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.