NPIMap

Organization Active NPI

Driscoll Dental, PLLC

  • General Practice Dentistry
  • Aberdeen, ID
National Provider Identifier
1124488507
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-4644 Issued in ID
Legal business name
DRISCOLL DENTAL, PLLC
Practice address
81 W Washington Ave
Aberdeen, ID 83210-4801
Phone
(208) 397-4198
NPI assigned
Feb 29, 2016
Last updated
Feb 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Authorized official

Name
Dr. Mitch J Driscoll, D.M.D.NPI 1790190692
Title
Owner
Phone
(208) 681-3798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-4644 ID Primary

Addresses

Primary practice location

81 W Washington Ave
Aberdeen, ID 83210-4801

Mailing address

81 W Washington Ave
Aberdeen, ID 83210-4801
Phone (208) 397-4198

National Provider Directory

National Provider Directory

Locations

81 W Washington Ave
Aberdeen, ID 83210
Phone (208) 397-4198

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1124488507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 W WASHINGTON AVE",
            "city": "ABERDEEN",
            "state": "ID",
            "postal_code": "832104801",
            "telephone_number": "208-397-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W WASHINGTON AVE",
            "city": "ABERDEEN",
            "state": "ID",
            "postal_code": "832104801",
            "telephone_number": "208-397-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRISCOLL DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "DRISCOLL",
        "authorized_official_first_name": "MITCH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-681-3798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.