KENT J ALLEN/ SHANNON WIDMIER


Address: 702 Center St W, Kimberly, ID 83341
Phone: 2084236444

KENT J ALLEN/ SHANNON WIDMIER (NPI# 1770769325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770769325
Entity Type Organization
Organization Name KENT J ALLEN/ SHANNON WIDMIER
Other Organization Name PHEASANT COVE DENTAL
Practice Address 702 Center St W
Kimberly
ID 83341
Mailing Address 702 Center Street West
Po Box B
Kimberly
ID 83341
Practice Telephone 2084236444
Practice Fax Number 2084236903
Mailing Telephone 2084236444
Enumeration Date 2008-01-14
Last Update Date 2008-01-14
Authorized Official Name DR. KENT J ALLEN (OWNER)
Authorized Official Telephone 2084236444
Authorized Official Credential D.D.S.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
D1767 CA Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
ID SMILES 9201818 01
ID 000876700 05

Other Provider/Organization Names

Other Name Type Code
PHEASANT COVE DENTAL Doing Business As Name - Organization

Office Location

Street Address 702 CENTER ST W
City KIMBERLY
State ID
Zip Code 83341

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730575671 Danton Lafey Bradshaw Dentist 702 Center St W, Kimberly, ID 83341-1722 2015-04-07

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063047470 Northstar In Home Support Services Social Worker 3323 East B 3600 North, Kimberly, ID 83341 2020-03-05
1851889182 Ammon Benjamin Birk Physical Therapist 940 Ballard Way, Kimberly, ID 83341 2018-04-23
1689161572 Medsource Mobility LLC Durable Medical Equipment & Medical Supplies 319 Highway 30, Unit 3, Kimberly, ID 83341 2018-04-17
1710072046 Helping Hands Sanctuary of Idaho Psychiatric Hospital 500 Polk St E, Kimberly, ID 83341 2006-10-03
1407954191 Kent J. Allen Dentist 702 Center Street West, Kimberly, ID 83341 2006-09-20
1841393212 Troy Alan Williams Dentist 1431 North Fillmore St, Twin Falls, ID 83341 2006-09-07
1386269983 Caroline M Riley Speech-Language Pathologist 113 Main Street, Kimberly, ID 83341 2020-06-10
1265512297 Northwest Bec Corp Assisted Living Facility 500 Polk St E, Kimberly, ID 83341 2006-10-16
1396842779 Shannon Widmier Dentist 702 Center Street West, Kimberly, ID 83341 2006-09-20
1760717672 Albert Paul Middleton Pharmacist 210 Main Street South, Kimberly, ID 83341-0000 2009-10-09
Find all providers in zip 83341

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700241890 Infinity Dental Pllc Dentist 622 Center St W, Kimberly, ID 83341-1720 2015-12-16
1750430088 Daniel Allen Larson Dentist 317 E Kimberly Ave, Kimberly, WI 54136-1406 2007-01-09
1407954191 Kent J. Allen Dentist 702 Center Street West, Kimberly, ID 83341 2006-09-20
1548273808 Edward Theodore Bekx Dentist 203 W Kimberly Ave, Kimberly, WI 54136 2006-08-15
1477583870 Joseph C Ferraro Dentist 1037-b Truman St., Kimberly, WI 54136 2006-07-03
1922296466 Timothy James Bouressa Dentist 500 W 3rd St, Pob 96, Kimberly, WI 54136-1305 2007-10-10
1215124862 Callie Irene Romenesko Dentist 1020 Truman St, Unit A, Kimberly, WI 54136-2215 2007-09-27
1215066626 James Patrick Meyer Dentist 1020 Truman St, Suite A, Kimberly, WI 54136-2211 2007-03-02
1396842779 Shannon Widmier Dentist 702 Center Street West, Kimberly, ID 83341 2006-09-20
1790798056 Kimberly Dental Associates LLP Dentist 203 W Kimberly Ave, Kimberly, WI 54136 2006-08-15
Find all providers in KIMBERLY

Competitor

Search similar providers

City KIMBERLY
Zip Code 83341

Improve Information

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Dataset Information

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.

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