Sandpoint Dental Cosmetics, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4103 Issued in ID

Legal business name

SANDPOINT DENTAL COSMETICS, PLLC

Practice address

30336 Highway 200
Suite a
Ponderay, ID 83852-9775

Phone

(208) 255-1255

Fax

(208) 263-0490

NPI assigned

May 20, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Johnson, DMD

Title

Doctor

Phone

(208) 255-1255

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1083933741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30336 HIGHWAY 200",
            "address_2": "SUITE A",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838529775",
            "telephone_number": "208-255-1255",
            "fax_number": "208-263-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30336 HIGHWAY 200",
            "address_2": "SUITE A",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838529775",
            "telephone_number": "208-255-1255",
            "fax_number": "208-263-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDPOINT DENTAL COSMETICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-20",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "208-255-1255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE ONE",
            "identifier": "1831385590",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Rial, PH.D.
• Joanna Richter
• Mario E Roxas, N.D.
• Sanctuary of Integrative Wellbeing
• Sandpoint Chiropractic PLLC
• Geri Lynn Schaaf, PT
• Michael David Schicker, DO
• Nancy J Schmidt, PHD, CADC, MAC, CHES
• Traci D Schmidt, PT
• Robert Seiberlich, NMD, LMT

• General Practice Dentistry in Ponderay, ID
• Providers in Ponderay, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.