NPIMap

Organization Active NPI

Brett D Naylor DDS PA

Doing business as Advanced Dental Center

  • Clinic/Center
  • Preston, ID
National Provider Identifier
1053422691
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
D3124 Issued in ID
Legal business name
BRETT D NAYLOR DDS PA
Doing business as
Advanced Dental Center
Practice address
25 N 1St E
Preston, ID 83263-1325
Phone
(208) 852-0770
Fax
(208) 852-3294
NPI assigned
Aug 31, 2006
Last updated
Aug 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Authorized official

Name
Dr. Brett D Naylor, D.D.S.NPI 1649212689
Title
President
Phone
(208) 852-0770

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
Clinic/Center 261Q00000X D3124 ID Primary

Addresses

Primary practice location

25 N 1St E
Preston, ID 83263-1325

Mailing address

25 N 1St E
Preston, ID 83263-1325
Phone (208) 852-0770

Other identifiers 3

IdentifierTypeStateIssuer
002748900MedicaidID
61895OtherIDBLUE CROSS NUMBER
803810OtherIDUNITED CONCORDIA NUMBER

Other names 1

  • Advanced Dental Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1053422691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631325",
            "telephone_number": "208-852-0770",
            "fax_number": "208-852-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631325",
            "telephone_number": "208-852-0770",
            "fax_number": "208-852-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT D NAYLOR DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "NAYLOR",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-852-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "D3124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002748900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "61895",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA NUMBER",
            "identifier": "803810",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Center",
            "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 Aug 11, 2008; 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.