Individual provider Active NPI

Jed Karl Zirker, D.D.S

  • General Practice Dentistry
  • Ammon, ID
National Provider Identifier
1124184817
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3708 Issued in ID
Practice address
1801 S Ammon Rd
Ammon, ID 83406-6860
Phone
(208) 528-7665
Fax
(208) 522-9556
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 D3708 ID Primary

Addresses

Primary practice location

1801 S Ammon Rd
Ammon, ID 83406-6860

Mailing address

1801 S Ammon Rd
Ammon, ID 83406-6860
Phone (208) 528-7665

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
D3708IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zirker Family Dentistry General Practice Past Accepting new patients
Zirker Family Dentistry Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124184817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 S AMMON RD",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066860",
            "telephone_number": "208-528-7665",
            "fax_number": "208-522-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S AMMON RD",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066860",
            "telephone_number": "208-528-7665",
            "fax_number": "208-522-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIRKER",
        "first_name": "JED",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.