Nicola G Zaboura

Primary specialty

DentistTaxonomy code 122300000X

License

D-5282 Issued in ID

Practice address

921 S 8TH Ave Stop 8088
Pocatello, ID 83209-0002

Phone

(440) 623-1264

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1063082543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 HAWTHORNE RD APT C302",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022891",
            "telephone_number": "440-623-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE STOP 8088",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090002",
            "telephone_number": "440-623-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABOURA",
        "first_name": "NICOLA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-5282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lippsusa@health.isu.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "921 S 8th Ave Stop 8088",
            "city": "Pocatello",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832090002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Young
• Kevin B Young, LCSW
• Tamara Young, LMSW
• Clinton E. Youngberg, D.C.
• Cindy Youngstrom, LCPC
• Margaret S Zajanc, DMD
• Cheryl Zaremba, M.S. CCC-SLP
• Karim Zeglam, MD
• Justin Dean Zierke, LCPC, NCC, ACADC
• Blaire M Zikratch-Clayson, DPT

• Dentist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.