Adam J Shipp, DMD, MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D3834EN Issued in ID

Practice address

1555 S Timesquare LN
Boise, ID 83709-8266

Phone

(208) 672-8860

Fax

(208) 672-8767

NPI assigned

Jan 11, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Idaho Endodontics

  • Endodontics
  • Boise, ID
  • NPI 1710509823
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114077369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098266",
            "telephone_number": "208-672-8860",
            "fax_number": "208-672-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098266",
            "telephone_number": "208-672-8860",
            "fax_number": "208-672-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "ADAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "ID",
            "license": "D3834EN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Shindledecker, SLP
• Shine Therapies PLLC
• Jillian A Shinn, LCSW
• Barry Jon Shinsel
• Yeime Priscila Marilu Shipley
• Misty Shipp, LMSW
• James Shippers, CRNA
• Christine Clair Shirazi, APPN
• Brynn Shireman, LMSW
• Andrea Corinne Shirley, NNP-BC

• Endodontics in Boise, ID
• Providers in Boise, ID by specialty
• Endodontics in Idaho

• 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.