DR. CHARLES JARED RANDALL (NPI# 1710035829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710035829 |
| Entity Type | Individual |
| Full Name | DR. CHARLES JARED RANDALL |
| Credential | DDS |
| Practice Address |
3285 E. 17th St. Ammon ID 83406-6758 |
| Practice Telephone | 2085233380 |
| Practice Fax Number | 2085233077 |
| Mailing Telephone | 2085233380 |
| Mailing Fax Number | 2085233077 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2009-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
D-3405-OR | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806122100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295814952 | Charles W Randall | Internal Medicine | 8550 Datapoint Dr, Suite 200, San Antonio, TX 78229-3270 | 2006-11-03 |
| 1881699668 | Charles Randall | Internal Medicine | 260 Merrimac St, Newburyport, MA 01950-2192 | 2005-06-17 |
| Street Address |
3285 E. 17TH ST. |
| City | AMMON |
| State | ID |
| Zip Code | 83406-6758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902032246 | Randall Orthodontics, P.a. | Dentist | 3285 E. 17th St., Ammon, ID 83406-6758 | 2009-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598383929 | Cristina Leon, Do Pa | Pediatrics | Idaho Falls Pediatrics, 3067 Eagle Dr, Ammon, ID 83406 | 2020-07-13 |
| 1144783499 | Mountain States Diabetes Relief, LLC | Internal Medicine | 4573 E Majestic, Idaho Falls, ID 83406 | 2019-04-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| 1225379183 | Sterling Hospital LLC | General Acute Care Hospital | 5412 S. Rock House Cir, Idaho Falls, ID 83406 | 2013-03-01 |
| 1710236823 | Flower D. Aston | Dietitian, Registered | 300 Bridger Drive, Ammon, ID 83406 | 2012-09-05 |
| 1558658468 | Nathan Myers | Pharmacist | 1901 South 2500 East, Idaho Falls, ID 83406 | 2011-06-30 |
| 1760719934 | Snf Ammon Operating Company LLC. | Skilled Nursing Facility | 3909 South 25th East, Ammon, ID 83406 | 2009-11-10 |
| 1316192370 | A Childs Smile | Dentist | 3299 E. 17th Street, Ammon, ID 83406 | 2008-11-18 |
| 1992968804 | Brandon D Gordon | Dentist | 7186 Sage View Cr, Idaho Falls, ID 83406 | 2008-07-10 |
| 1891996526 | Help, Inc. | Community/Behavioral Health | 1465 Hoopes Ave, Idaho Falls, ID 83406 | 2007-05-30 |
| Find all providers in zip 83406 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902032246 | Randall Orthodontics, P.a. | Dentist | 3285 E. 17th St., Ammon, ID 83406-6758 | 2009-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1093314932 | Smile Bar LLC | Dentist | 602 N Calgary Ct Ste 302, Post Falls, ID 83854-4000 | 2020-10-21 |
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1194369371 | Ikdo Emmett LLC | Dentist | 314 S Washington Ave, Emmett, ID 83617-2952 | 2019-10-31 |
| 1861954026 | Ikdo Star LLC | Dentist | 12190 W Evely Pines Ln, Star, ID 83669-6126 | 2019-04-04 |
| 1356815427 | Jkb Orthodontics | Dentist | 621 N Midland Blvd, Nampa, ID 83651-6525 | 2019-01-11 |
| 1184108706 | Ikdo Fruitland LLC | Dentist | 1619 N Whitley Dr, Fruitland, ID 83619-2162 | 2018-09-19 |
| 1205330420 | Jendy Pllc | Dentist | 2300 W Everest Ln Ste 125, Meridian, ID 83646-6113 | 2018-03-21 |
| 1841686649 | Cascade Dental, PC | Dentist | 839 S Main Street, Cascade, ID 83611 | 2015-04-09 |
| 1194169649 | Jordan Rodney Hillam | Dentist | 758 E 65th S, Idaho Falls, ID 83404-7696 | 2013-04-25 |
| 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.