NPIMap

Organization Active NPI

Justin Carter DDS P.C.

Doing business as Canyon Creek Dental

  • Dentist
  • Preston, ID
National Provider Identifier
1033849104
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JUSTIN CARTER DDS P.C.
Doing business as
Canyon Creek Dental
Practice address
395 E 600 S
Preston, ID 83263-4901
Phone
(208) 852-0194
NPI assigned
Jun 13, 2022
Last updated
Jun 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Dr. Justin Carter, DDSNPI 1386804458
Title
Partner
Phone
(435) 757-3332

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
Dentist 122300000X NU Primary

Addresses

Primary practice location

395 E 600 S
Preston, ID 83263-4901

Mailing address

395 E 600 S
Preston, ID 83263-4901
Phone (208) 852-0194

Other names 1

  • Canyon Creek Dental Doing business as

National Provider Directory

National Provider Directory

Locations

395 E 600 S
Preston, ID 83263
Phone (208) 852-0194

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1033849104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 E 600 S",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832634901",
            "telephone_number": "208-852-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 E 600 S",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832634901",
            "telephone_number": "208-852-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN CARTER DDS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "435-757-3332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Creek Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Preston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.