Organization Active NPI

Christian C. Cusimano DDS, Ms, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Nampa, ID
National Provider Identifier
1083784946
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D-3247-OR Issued in ID
Legal business name
CHRISTIAN C. CUSIMANO DDS, MS, PC
Practice address
345 W Iowa Ave
Nampa, ID 83686-2856
Phone
(208) 467-4362
Fax
(208) 463-9080
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Dr. Chris C. Cusimano, DDS, MS
Title
Orthodontist
Phone
(208) 467-4362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X D-3247-OR ID Primary

Addresses

Primary practice location

345 W Iowa Ave
Nampa, ID 83686-2856

Mailing address

345 W Iowa Ave
Nampa, ID 83686-2856
Phone (208) 467-4362

National Provider Directory

National Provider Directory

Locations

345 W Iowa Ave
Nampa, ID 83686
Phone (208) 467-4362

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1083784946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-4362",
            "fax_number": "208-463-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-4362",
            "fax_number": "208-463-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN C. CUSIMANO DDS, MS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "CUSIMANO",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "208-467-4362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-3247-OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.