MOUNTAIN RIVER DENTAL (NPI# 1912136433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912136433 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN RIVER DENTAL |
| Practice Address |
404 Lupine Drive Victor ID 83455-0487 |
| Mailing Address |
404 Lupine Drive P.o. Box 487 Victor ID 83455-0487 |
| Practice Telephone | 2087878100 |
| Practice Fax Number | 2087878101 |
| Mailing Telephone | 2087878100 |
| Mailing Fax Number | 2087878101 |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |
| Authorized Official Name | DR. RICHARD H GEORGE (OWNER) |
| Authorized Official Telephone | 2087878100 |
| Authorized Official Credential | D.M.D. |
| 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 |
404 LUPINE DRIVE |
| City | VICTOR |
| State | ID |
| Zip Code | 83455-0487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376050385 | Hunters Inc | Pharmacy | 81 N. Main St., Victor, ID 83455 | 2017-12-29 |
| 1194109306 | Emily Williams | Occupational Therapist | 73 N Main Street, Victor, ID 83455 | 2015-07-17 |
| 1073918173 | Teton Valley Vision PC | Optometrist | 7389 S Hwy 33, Ste B, Victor, ID 83455 | 2014-10-31 |
| 1437440591 | Nathan Richard George | Dentist | 7726 Lupine Lane, Victor, ID 83455 | 2011-04-25 |
| 1245537695 | Erin N Borbet | Acupuncturist | 108 W Center St Unit 3, Victor, ID 83455 | 2011-02-22 |
| 1336457837 | Grand Teton Dental Care | Clinic/Center | 741 South 50 West, Suite A, Victor, ID 83455 | 2010-09-17 |
| 1598086126 | Childs Play, LLC | Speech-Language Pathologist | 73 North Main, Victor, ID 83455 | 2010-06-17 |
| 1891025656 | Phillips Therapy Incorporated | Occupational Therapist | 73 North Main St., Suite 3, Victor, ID 83455 | 2009-12-30 |
| 1861621278 | Elmer Raymond Cherry Iv | Dentist | 7389 S. Hwy. 33 Suite A, Victor, ID 83455 | 2009-07-07 |
| 1861534133 | Amy Herzog | Counselor | 175 Brome Dr., #7, Victor, ID 83455 | 2007-02-13 |
| Find all providers in zip 83455 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336457837 | Grand Teton Dental Care | Clinic/Center | 741 South 50 West, Suite A, Victor, ID 83455 | 2010-09-17 |
| 1083267074 | Sheets Family Dental Hygiene, LLC | Clinic/Center | 807 Portland Ave, Victor, CO 80860-8086 | 2019-07-19 |
| 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 |
| 1720698608 | Club 32 Dental | Clinic/Center | 624 3rd St S, Nampa, ID 83651-3840 | 2020-08-05 |
| 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 |
| 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.