NPIMap

Organization Active NPI

Idaho Smiles Assoc. PLLS

  • General Practice Dentistry
  • Boise, ID
National Provider Identifier
1003116542
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-2065 Issued in ID
Legal business name
IDAHO SMILES ASSOC. PLLS
Practice address
305 W Idaho St
Boise, ID 83702-6040
Phone
(208) 343-7271
NPI assigned
Nov 1, 2010
Last updated
Nov 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeff Tuller, DDS
Title
Owner/Dentist
Phone
(208) 343-7271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-2065 ID Primary

Addresses

Primary practice location

305 W Idaho St
Boise, ID 83702-6040

Mailing address

305 W Idaho St
Boise, ID 83702-6040
Phone (208) 343-7271

Other identifiers 1

IdentifierTypeStateIssuer
1285641589OtherIDNPI

National Provider Directory

National Provider Directory
Tax ID family
Idaho Smiles Assoc PLLS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1003116542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W IDAHO ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026040",
            "telephone_number": "208-343-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W IDAHO ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026040",
            "telephone_number": "208-343-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO SMILES ASSOC. PLLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "TULLER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "208-343-7271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-2065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285641589",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.