Kevin Michael Elliott, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D3826 Issued in ID

Practice address

1097 N Jacksonmill Ave
Kuna, ID 83634-2086

Phone

(208) 519-7171

Fax

(208) 382-3668

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornerstone Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Cascade, ID
  • NPI 1962629527
  NPD (past) Authorized official
• Idaho Dental Professionals, P.C.

  • General Practice Dentistry
  • Kuna, ID
  • NPI 1366135857
  NPD (past)
• Two Rivers Dental

  • Dental Clinic/Center
  • Cascade, ID
  • NPI 1356581326
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1104910199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 N JACKSONMILL AVE",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342086",
            "telephone_number": "208-519-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 N JACKSONMILL AVE",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342086",
            "telephone_number": "208-519-7171",
            "fax_number": "208-382-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Dreher, RN
• Sabrina Denise Dunn
• Brandilyn Durrant
• Amanda Irene Dymen
• Dustin David Elliott
• Rocky Wade Elsasser, DPT
• Ryan R. Emry, M.ED., M.A., LPC
• Jeffrey Epperson
• Julio Orlando Escobar, D.D.S.
• Heather Esposito, LPC

• Dentist in Kuna, ID
• Providers in Kuna, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.