Individual provider Active NPI

Diana Rosa Pothier, DMD

  • Dentist
  • Meridian, ID
National Provider Identifier
1053666255
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-4448 Issued in ID
Practice address
1311 E Central Dr
Meridian, ID 83642
Phone
(208) 373-1871
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-4448 ID Primary

Addresses

Primary practice location

1311 E Central Dr
Meridian, ID 83642

Mailing address

398 S 9TH St Ste 230
Boise, ID 83702-7156
Phone (208) 336-0003

Other practice location 1

7878 W Ustick Rd Ste 101
Boise, ID 83704-5006
Phone (208) 376-2920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D-4448IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce D.M.D. and Ririe D.D.S., P.a. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1053666255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 S 9TH ST STE 230",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027156",
            "telephone_number": "208-336-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E CENTRAL DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-373-1871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7878 W Ustick Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837045006",
            "country_code": "US",
            "telephone_number": "208-376-2920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTHIER",
        "first_name": "DIANA",
        "middle_name": "ROSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.