Centerpoint Orthodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D-1766-OR Issued in ID

Legal business name

CENTERPOINT ORTHODONTICS

Practice address

5220 N Eagle Rd
Boise, ID 83713-0945

Phone

(208) 323-4800

Fax

(208) 323-1299

NPI assigned

Jan 7, 2009

Last updated

Jan 7, 2009By 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

Dr. Robert J Agnetta, DDS,MS,PA

Title

Owner

Phone

(208) 323-4800

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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.

• Jon Miler, DDS,MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boise, ID
  • NPI 1588879399
  NPD (past)

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1073750469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "208-323-4800",
            "fax_number": "208-323-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "208-323-4800",
            "fax_number": "208-323-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERPOINT ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "AGNETTA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-323-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MS,PA"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-1766-OR",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-3856",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO SMILES/MILER",
            "identifier": "9201910",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202027",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Blanca Estela Cervantes, LMT
• Marcos Antonio Cervantes, PHARMD
• Brian C Cey, NP

• Dental Clinic/Center in Boise, ID
• Providers in Boise, 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 7, 2009; 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.