Teton Valley Dental Center PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D3634 Issued in ID

Legal business name

TETON VALLEY DENTAL CENTER PLLC

Practice address

235 E. Wallace Ave.
Driggs, ID 83442

Phone

(208) 354-8181

Fax

(208) 354-8182

NPI assigned

Jan 25, 2012

Last updated

Jan 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James C Allen, DDS

Title

President

Phone

(208) 354-8181

Specialties & licenses 2

Addresses

Tax ID family

Teton Valley Dental Center PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Teton Valley Dental Center PLLC

  • Dental Clinic/Center
  • Driggs, ID
  • NPI 1801112628
  NPD tax ID

Locations

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1063783868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "address_2": "235 E., WALLACE AVE.",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834220791",
            "telephone_number": "208-354-8181",
            "fax_number": "208-354-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E. WALLACE AVE.",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "83442",
            "telephone_number": "208-354-8181",
            "fax_number": "208-354-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON VALLEY DENTAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-354-8181",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D3634",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D1657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teton School District #401
• Teton Valley Counseling
• Teton Valley Counseling, Inc
• Teton Valley Counseling, Inc
• Teton Valley Counseling, Inc.
• Teton Valley Dental Center PLLC
• Teton Valley Health Care Inc (Driggs Clinic)
• Teton Valley Health Care Inc
• Teton Valley Health Care Inc (Teton Valley Health Care)
• Teton Valley Health Care, Inc (Teton Valley Health Care Swing Bed Unit)

• Dental Clinic/Center in Driggs, ID
• Providers in Driggs, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.