LEGACY DENTAL (NPI# 1841204609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841204609 |
| Entity Type | Organization |
| Organization Name | LEGACY DENTAL |
| Practice Address |
1685 Pancheri Dr Idaho Falls ID 83402-3169 |
| Mailing Address |
4935 Jupiter Hills Dr Idaho Falls ID 83401-6344 |
| Practice Telephone | 2085230840 |
| Practice Fax Number | 2085230921 |
| Mailing Telephone | 2085287537 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | OLIVER ONEAL THUERNAGLE (DENTIST) |
| Authorized Official Telephone | 2085230840 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D-3902 | ID | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518209659 | Legacy Dental | Dentist | 1345 E 3900 S Ste 116, Salt Lake City, UT 84124-4407 | 2013-03-26 |
| 1861796229 | Legacy Dental | Preferred Provider Organization | 4993 W Atlantic Ave, Delray Beach, FL 33445-3850 | 2010-12-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Ohio Business Entities | LEGACY DENTAL CARE - JASON WARN, DDS, LLC | 2150 Milton Road, #210, University Heights, OH 44118 |
| Virginia Business Entities | Legacy Dental LLC | 305 W Fayette St Ste 1613, Baltimore, Maryland 21201 |
| Iowa Business Entities | LEGACY DENTAL, P.C. | 4409 Sw 9th Street, Des Moines, IA 50315 |
| Street Address |
1685 PANCHERI DR |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215958376 | Oliver Oneal Thuernagle | Dentist | 1685 Pancheri Dr, Idaho Falls, ID 83402-3169 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396236501 | John Andrew Chappell | Dentist | 1820 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2018-05-23 |
| 1326395385 | Eagle Rock Dental Care Pllc | Dentist | 2205 Channing Way Ste B, Idaho Falls, ID 83404-8016 | 2012-08-09 |
| 1194046037 | Esther B. Machen | Dentist | 3500 Potomac Way, Suite 200, Idaho Falls, ID 83404-4974 | 2010-06-15 |
| 1003144114 | Sunnyside Dental Care PC | Dentist | 1520 Elk Creek Dr, Idaho Falls, ID 83404-8322 | 2009-12-01 |
| 1033443478 | Soft Touch Dental | Dentist | 3350 S 15 Th E, Idaho Falls, ID 83404 | 2009-10-01 |
| 1134356140 | Riverwest Dental, Pllc | Dentist | 1655 Pancheri Dr., Idaho Falls, ID 83402 | 2009-06-17 |
| 1932368222 | Elison Dental Center | Dentist | 3656 Washington Pkwy, Idaho Falls, ID 83404-7573 | 2008-06-03 |
| 1851590152 | Mark Aaron Chambers | Dentist | 2860 Valencia Dr Ste 101, Idaho Falls, ID 83404-7597 | 2007-07-16 |
| 1306053350 | Layne K Mccord | Dentist | 3411 Merlin Dr, Idaho Falls, ID 83404-7430 | 2007-05-17 |
| 1891837050 | Nathan Jay Crandall | Dentist | 1991 W Broadway St # 1, Idaho Falls, ID 83402-3041 | 2007-02-13 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on LEGACY DENTAL.
| 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.