CLUB 32 DENTAL (NPI# 1720698608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720698608 |
| Entity Type | Organization |
| Organization Name | CLUB 32 DENTAL |
| Practice Address |
624 3rd St S Nampa ID 83651-3840 |
| Practice Telephone | 2084662456 |
| Practice Fax Number | 2083180227 |
| Mailing Telephone | 2084662456 |
| Mailing Fax Number | 2083180227 |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | KIM BENSON KELLER (OWNER) |
| Authorized Official Telephone | 2084662456 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
624 3RD ST S |
| City | NAMPA |
| State | ID |
| Zip Code | 83651-3840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447863956 | Stephen C Bryant | Dentist | 624 3rd St S, Nampa, ID 83651-3840 | 2020-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376090985 | Stephen Michael Wren | Physician Assistant | 11035 W Karcher Rd, Nampa, ID 83651 | 2016-09-01 |
| 1104203157 | Jeremy Thorson | Social Worker | 456 West Orchard Ave., Apt D305, Nampa, ID 83651 | 2015-04-29 |
| 1134527708 | Community Health Clinics Inc | Clinic/Center | 207 1st Street S, Nampa, ID 83651 | 2014-12-15 |
| 1326455429 | Michelle Murchie | Pharmacist | 175 S. Middleton Rd, Nampa, ID 83651 | 2014-07-21 |
| 1700215373 | Stanley A Gillett | Chiropractor | 107 14th Ave S, Nampa, ID 83651 | 2013-11-04 |
| 1477996205 | James L Fries | Counselor | 847 Park Centre Way, Suite 5, Nampa, ID 83651 | 2013-04-11 |
| 1023367240 | Erin Westfall | Speech-Language Pathologist | 168 Mcclure Avenue, Nampa, ID 83651 | 2012-09-04 |
| 1487949475 | Erik Steven Linn | Family Medicine | 11035 W. Karcher Road, Nampa, ID 83651 | 2011-06-17 |
| 1720398647 | At Your Service Home Health Care LLC | In Home Supportive Care | 321 2nd St S Ste 103, Nampa, ID 83651 | 2010-10-13 |
| 1144544206 | Petra Morrison | Community/Behavioral Health | 1031 W. Sanetta St., Nampa, ID 83651 | 2010-03-18 |
| Find all providers in zip 83651 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053705178 | Onsite Dental, Pllc | Clinic/Center | 524 E Fujii Dr, Nampa, ID 83686-6906 | 2015-03-26 |
| 1407152721 | Idaho Center Dental Care | Clinic/Center | 5826 E Franklin Rd, Nampa, ID 83687-5020 | 2011-02-03 |
| 1881602639 | Community Health Clinics Inc | Clinic/Center | 11136 Moss Lane, Nampa, ID 83687 | 2006-08-04 |
| 1891396776 | Happy Healthy Smiles LLC | Clinic/Center | 1436 S Edgewater Cir, Nampa, ID 83686-5051 | 2020-11-05 |
| 1568944502 | Ns South | Clinic/Center | 1705 12th Ave Rd, Nampa, ID 83686-6104 | 2018-09-06 |
| 1265979629 | Community Health Clinics, Inc. | Clinic/Center | 207 1st St S, Nampa, ID 83651-3703 | 2017-01-24 |
| 1457593584 | Todd L Squires Ddc Pllc | Clinic/Center | 2811 12th Ave Rd, Nampa, ID 83686 | 2009-04-06 |
| 1093977647 | Russell C. Pool, Dmd, Pa | Clinic/Center | 109 12th Ave Rd, Nampa, ID 83686-5047 | 2008-06-25 |
| 1689849598 | Kelly E. Carlen, Dds Pllc | Clinic/Center | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2008-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864384 | Kuna Kids Dentistry PC | Clinic/Center | 1385 N Jacksonmill Ave, Kuna, ID 83634-2042 | 2020-09-08 |
| 1720691785 | Advanced Dentistry of Mccall | Clinic/Center | 313 Deinhard Ln, Mccall, ID 83638-4703 | 2020-08-28 |
| 1831732502 | Hughes Dental Pllc | Clinic/Center | 834 Falls Ave Ste 2030, Twin Falls, ID 83301-3365 | 2019-10-24 |
| 1083279087 | Idaho Buckeye Inc | Clinic/Center | 1537 2nd Ave S, Payette, ID 83661-2919 | 2019-05-06 |
| 1639637168 | Scott Carter, Inc | Clinic/Center | 982 Banks Lowman Rd, Garden Valley, ID 83622 | 2019-03-04 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 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 |
| 1841643533 | Dental Partners Ustick Pllc | Clinic/Center | 4403 E Ustick Rd # 104, Caldwell, ID 83605-6802 | 2016-07-18 |
| 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.