NPIMap

Individual provider Active NPI

Ernest A Meshack-Hart, DDS

  • General Practice Dentistry
  • Boise, ID
National Provider Identifier
1033138235
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-4543 Issued in ID
Practice address
2301 N 36TH St Ste 102
Boise, ID 83703-5202
Phone
(208) 336-8801
Fax
(208) 466-5359
NPI assigned
Jul 19, 2006
Last updated
Apr 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-4543 ID Primary

Addresses

Primary practice location

2301 N 36TH St Ste 102
Boise, ID 83703-5202

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 467-4431

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
I20240718002117 ID Practitioner - Dentist 0042488579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-4543IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Community Health Clinics, Inc. Current Accepting new patients
Community Health Clinics, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients

Locations

400 N Allumbaugh St
Boise, ID 83704
Phone (208) 377-9180

848 S La Cassia Dr
Boise, ID 83705
Phone (208) 344-0086

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

201 S Paradise Ave
Middleton, ID 83644
Phone (208) 585-0048

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

Organizations & group practices 12

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1033138235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N 36TH ST STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837035202",
            "telephone_number": "208-336-8801",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESHACK-HART",
        "first_name": "ERNEST",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.