NPIMap

Organization Active NPI

Two Rivers Dental, PLLC

  • General Practice Dentistry
  • Salmon, ID
National Provider Identifier
1043416910
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3280 Issued in ID
Legal business name
TWO RIVERS DENTAL, PLLC
Practice address
100 Courthouse Dr
Salmon, ID 83467-3919
Phone
(208) 756-1002
NPI assigned
Jun 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Shane Newton, DMD, PA
Title
Owner
Phone
(208) 756-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D3280 ID Primary

Addresses

Primary practice location

100 Courthouse Dr
Salmon, ID 83467-3919

Mailing address

100 Courthouse Dr
Salmon, ID 83467-3919
Phone (208) 756-1002

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Dental PLLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

100 Courthouse Dr
Salmon, ID 83467
Phone (208) 756-1002

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043416910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COURTHOUSE DR",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834673919",
            "telephone_number": "208-756-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COURTHOUSE DR",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834673919",
            "telephone_number": "208-756-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-756-1002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.