Individual provider Active NPI

Steve Paul Garn, D.D.S.

  • General Practice Dentistry
  • Burley, ID
National Provider Identifier
1104849629
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D2071 Issued in ID
Practice address
2200 Park Ave
Suite 2
Burley, ID 83318-2186
Phone
(208) 678-8188
Fax
(208) 678-3170
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D2071 ID Primary

Addresses

Primary practice location

2200 Park Ave
Suite 2
Burley, ID 83318-2186

Mailing address

2200 Park Ave
Suite 2
Burley, ID 83318-2186
Phone (208) 678-8188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D2071IDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104849629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARK AVE",
            "address_2": "SUITE 2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182186",
            "telephone_number": "208-678-8188",
            "fax_number": "208-678-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARK AVE",
            "address_2": "SUITE 2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182186",
            "telephone_number": "208-678-8188",
            "fax_number": "208-678-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARN",
        "first_name": "STEVE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D2071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.