DENTURE CLINIC OF POCATELLO, INC. (NPI# 1720419674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720419674 |
| Entity Type | Organization |
| Organization Name | DENTURE CLINIC OF POCATELLO, INC. |
| Practice Address |
115 S 15th Ave Ste D Pocatello ID 83201-4052 |
| Practice Telephone | 2082322558 |
| Practice Fax Number | 2082322558 |
| Mailing Telephone | 2082322558 |
| Mailing Fax Number | 2082322558 |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |
| Authorized Official Name | MR. GENO ALAN GIOVANINI (OWNER) |
| Authorized Official Telephone | 2082322558 |
| Authorized Official Credential | L.D |
| Is Organization Subpart | Y |
| Parent Organization Name | DENTURE CLINIC OF POCATELLO, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122400000X | Denturist | LD-98 | ID | Dental Providers |
| Street Address |
115 S 15TH AVE STE D |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1699817684 | Denture Arts, Inc. | Denturist | 1448 E. Center, Suite A-1, Pocatello, ID 83201 | 2007-02-13 |
| 1215058292 | Richard R Howell | Denturist | 1448 E Center St, Suite A-1, Pocatello, ID 83201-4132 | 2007-04-03 |
| 1134240120 | Darcy Cameron Kerr | Denturist | 1155 Pocatello Creek Rd., Pocatello, ID 83201 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750944344 | Amanda Jodi Rowe | Denturist | 10480 W Garverdale Ct Ste 804a, Boise, ID 83704-5477 | 2019-04-18 |
| 1093165524 | Cody Waid | Denturist | 1833 N Lakes Pl, Meridian, ID 83646-1921 | 2016-06-15 |
| 1366800583 | Nicholas Sander | Denturist | 124 11th Ave N, Buhl, ID 83316-1602 | 2016-02-02 |
| 1659760684 | Charles Rollin Westerberg | Denturist | 6710 W. Overland Rd., Boise, ID 83709 | 2015-01-14 |
| 1053614248 | Public Denture Center | Denturist | 6710 W Overland Rd, Boise, ID 83709-2032 | 2010-12-10 |
| 1689990426 | Denture Service LLC | Denturist | 330 5th St, Lewiston, ID 83501-2408 | 2010-04-19 |
| 1598081556 | Rebecca Lynn Westerberg | Denturist | 2124 Blaine St, Caldwell, ID 83605-4426 | 2010-04-15 |
| 1386875268 | Fred Elmer Giovanini | Denturist | 505 1st Street, Suite A, Idaho Falls, ID 83401 | 2009-07-27 |
| 1013151083 | Glen M Castor | Denturist | 306 12th Ave S, Nampa, ID 83651-4246 | 2009-04-21 |
| 1609045681 | Carla Roxann Wolfrum | Denturist | 204 E Superior St, Suite #9, Sandpoint, ID 83864-1275 | 2008-02-25 |
| 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.