Active NPI
Trent Miner, DMD
- Pediatric Dentistry
- Kuna, ID
National Provider Identifier
1114393360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D-4738-PD
- Practice address
- 1378 N Meridian Rd Ste 150
Kuna, ID 83634-1687 - Phone
- (208) 606-4816
- NPI assigned
- Aug 11, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D-4738-PD | ID | Primary |
Addresses
Primary practice location
1378 N Meridian Rd Ste 150
Kuna, ID 83634-1687
Mailing address
2728 Westmoor CT SW
Olympia, WA 98502-5779
Phone (801) 376-9580
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
| License | State | Type | Specialty |
|---|---|---|---|
| D-4738-PD | ID | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1114393360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2728 WESTMOOR CT SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985025779",
"telephone_number": "801-376-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1378 N MERIDIAN RD STE 150",
"city": "KUNA",
"state": "ID",
"postal_code": "836341687",
"telephone_number": "208-606-4816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINER",
"first_name": "TRENT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-11",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "ID",
"license": "D-4738-PD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.