NPIMap

Organization Active NPI

Cottonwood Dental Care, PA

  • Dental Clinic/Center
  • Driggs, ID
National Provider Identifier
1073776050
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D3890 Issued in ID
Legal business name
COTTONWOOD DENTAL CARE, PA
Practice address
180 S Main St
Suite B2
Driggs, ID 83422-5034
Phone
(208) 354-9700
Fax
(208) 354-9701
NPI assigned
Jul 9, 2008
Last updated
Jul 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Dr. Stuart Marshall, D.D.S.NPI 1215026315
Title
Dentist
Phone
(208) 354-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D3890 ID Primary

Addresses

Primary practice location

180 S Main St
Suite B2
Driggs, ID 83422-5034

Mailing address

180 S Main St
Suite B2
Driggs, ID 83422-5034
Phone (208) 354-9700

National Provider Directory

National Provider Directory

Locations

180 S Main St
Ste B2
Driggs, ID 83422
Phone (208) 354-9700

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1073776050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "address_2": "SUITE B2",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225034",
            "telephone_number": "208-354-9700",
            "fax_number": "208-354-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "address_2": "SUITE B2",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225034",
            "telephone_number": "208-354-9700",
            "fax_number": "208-354-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD DENTAL CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-354-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D3890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Driggs, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.