NPIMap

Organization Active NPI

Boise Towne Square Dental

  • General Practice Dentistry
  • Boise, ID
National Provider Identifier
1104026822
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3877 Issued in ID
Legal business name
BOISE TOWNE SQUARE DENTAL
Practice address
7677 W Emerald St
Boise, ID 83704-9018
Phone
(208) 888-0662
Fax
(208) 888-0863
NPI assigned
Jul 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Authorized official

Name
Dr. Wade Pilling, D.M.D
Title
Owner
Phone
(208) 888-0662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D3877 ID Primary

Addresses

Primary practice location

7677 W Emerald St
Boise, ID 83704-9018

Mailing address

7677 W Emerald St
Boise, ID 83704-9018
Phone (208) 888-0662

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1104026822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7677 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049018",
            "telephone_number": "208-888-0662",
            "fax_number": "208-888-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7677 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049018",
            "telephone_number": "208-888-0662",
            "fax_number": "208-888-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE TOWNE SQUARE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "PILLING",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-888-0662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.