Loren E. Short, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D-4121-OR Issued in ID

Practice address

4203 Clock Tower Ave.
Caldwell, ID 83607-5006

Phone

(208) 454-4112

Fax

(208) 454-5155

NPI assigned

Jan 17, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Clock Tower Orthodontics, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Caldwell, ID
  • NPI 1942471966
  NPD (past) Authorized official

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1053597245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 CLOCK TOWER AVE.",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075006",
            "telephone_number": "208-454-4112",
            "fax_number": "208-454-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 CLOCK TOWER AVE.",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075006",
            "telephone_number": "208-454-4112",
            "fax_number": "208-454-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "LOREN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-4121-OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Paul Shanks, FNP
• Leigh Sharma, PH.D.
• Asha Sharp, LMSW
• Michelle Shaughnessy, FNTP, BCHN, RWS
• Sydney Shore
• Jeffrey M Siegel
• John Siler
• Jocele Skinner, MD
• Kira Ann Skroh, ATC. ATL
• Michael Slack, DO

• Orthodontics and Dentofacial Orthopedics Dentistry in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.