NPIMap

Individual provider Active NPI

John Stanley Kriz, DDS

  • Dentist
  • Boise, ID
National Provider Identifier
1003919986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D1499 Issued in ID
Practice address
7235 Emerald St
Suite B
Boise, ID 83704-8600
Phone
(208) 376-7740
Fax
(208) 376-0468
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D1499 ID Primary

Addresses

Primary practice location

7235 Emerald St
Suite B
Boise, ID 83704-8600

Mailing address

7235 Emerald St
Suite B
Boise, ID 83704-8600
Phone (208) 376-7740

Other identifiers 1

IdentifierTypeStateIssuer
6G587OtherIDBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108001651 ID Order and Referring Only - DentistPractitioner - Dentist 1557663424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D1499IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. PastSince Aug 31, 2022 Accepting new patients
Boise Bench Dentistry Dentist PastSince Jun 6, 2021 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 16

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Terry Reilly Health ServicesCaldwell, ID, CCN 131833 Federally qualified health center Corporate Director Aug 31, 2022
Terry Reilly Health ServicesBoise, ID, CCN 131810 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesMelba, ID, CCN 131821 Federally qualified health center Corporate Director Aug 23, 2023
Terry Reilley Health ServicesMarsing, ID, CCN 131807 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesNampa, ID, CCN 131809 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesHomedale, ID, CCN 131808 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesNampa, ID, CCN 131855 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesNampa, ID, CCN 131860 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesCaldwell, ID, CCN 131863 Federally qualified health center Corporate Director Aug 31, 2022
Terry Reilly Health ServicesBoise, ID, CCN 131870 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesBoise, ID, CCN 131892 Federally qualified health center Corporate Director Oct 6, 2021
Terry Reilly Health ServicesBoise, ID, CCN 131010 Federally qualified health center Corporate Director Aug 31, 2022
Terry Reilly Health ServicesMeridian, ID, CCN 131030 Federally qualified health center Corporate Director Aug 31, 2022
Terry Reilly Health ServicesCaldwell, ID, CCN 131032 Federally qualified health center Corporate Director Aug 31, 2022
Terry Reilly Health ServicesNampa, ID, CCN 131039 Federally qualified health center Corporate Director Aug 31, 2022
Terry Reilly Health ServicesBoise, ID, CCN 131049 Federally qualified health center Corporate Officer Sep 30, 2024

Owned or controlled facilities with NPI records 16

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 16

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003919986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 EMERALD ST",
            "address_2": "SUITE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048600",
            "telephone_number": "208-376-7740",
            "fax_number": "208-376-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 EMERALD ST",
            "address_2": "SUITE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048600",
            "telephone_number": "208-376-7740",
            "fax_number": "208-376-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIZ",
        "first_name": "JOHN",
        "middle_name": "STANLEY",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D1499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6G587",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.