NPIMap

Organization Active NPI

James Cannon Allen DDS PC

  • General Practice Dentistry
  • Rexburg, ID
National Provider Identifier
1033461660
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3634 Issued in ID
Legal business name
JAMES CANNON ALLEN DDS PC
Doing business as
Rockhouse Dentistry
Practice address
106 E 1St North
Rexburg, ID 83440
Phone
(208) 356-5600
Fax
(208) 419-0202
NPI assigned
Oct 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Authorized official

Name
Dr. James Cannon Allen, DDSNPI 1356352090
Title
Dentist
Phone
(208) 356-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D-3634 ID Primary

Addresses

Primary practice location

106 E 1St North
Rexburg, ID 83440

Mailing address

106 E 1St North
Rexburg, ID 83440
Phone (208) 356-5600

Other identifiers 1

IdentifierTypeStateIssuer
9201769MedicaidID

Other names 1

  • Rockhouse Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

106 E 1st N
Rexburg, ID 83440
Phone (208) 356-5600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1033461660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E 1ST NORTH",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "83440",
            "telephone_number": "208-356-5600",
            "fax_number": "208-419-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E 1ST NORTH",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "83440",
            "telephone_number": "208-356-5600",
            "fax_number": "208-419-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES CANNON ALLEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CANNON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-356-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201769",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockhouse Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.