Joel Edward Courtial, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1743 Issued in ID

Practice address

151 Stierman Way
Eagle, ID 83616-5163

Phone

(208) 939-4111

Fax

(208) 939-3701

NPI assigned

Nov 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124193123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 STIERMAN WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165163",
            "telephone_number": "208-939-4111",
            "fax_number": "208-939-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 STIERMAN WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165163",
            "telephone_number": "208-939-4111",
            "fax_number": "208-939-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTIAL",
        "first_name": "JOEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Copeland, BSW
• Kimberly Cordero
• Cornerstone Caregiving West LLC
• Counseling Associates PLLC
• Counseling Solutions Center LLC (Jessica Bullwinkle, MA, LMFT)
• Angela Ann Coyne, PA
• Josh Crank, D.M.D.
• Andrew Reed Crawford, PA-C
• Kellee J Crockett, PA-C
• Steven Anthony Cronen

• General Practice Dentistry in Eagle, ID
• Providers in Eagle, ID by specialty
• General Practice Dentistry 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.
• 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.