Town Square Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4143 Issued in ID

Legal business name

TOWN SQUARE DENTAL PLLC

Practice address

502 8TH St
Rupert, ID 83350-1417

Phone

(208) 436-4747

Fax

(208) 436-9683

NPI assigned

Dec 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Nathan A Catmull, DDSNPI 1457510042

Title

Owner

Phone

(208) 436-4747

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Nathan A Catmull, DDS

  • General Practice Dentistry
  • Rupert, ID
  • NPI 1457510042
  NPD (past) Authorized official
• John Arthur Simpson, DDS

  • General Practice Dentistry
  • Rupert, ID
  • NPI 1427097963
  NPD (past)

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1124534433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 8TH ST",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501417",
            "telephone_number": "208-436-4747",
            "fax_number": "208-436-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 8TH ST",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501417",
            "telephone_number": "208-436-4747",
            "fax_number": "208-436-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN SQUARE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "CATMULL",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-436-4747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28443",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linsey Sunderland
• Michael Sunderland
• Swenson M.D. Inc.
• Jeffrey Scott Swenson, MD
• Casie Taylor, FNP
• Maria L Vega
• Victoria Rose Vega, PA-C
• David Dale Wageman, DO
• David O Ward, PHARMD
• Charle A Warren, D.D.S.

• General Practice Dentistry in Rupert, ID
• Providers in Rupert, 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 Sep 27, 2023; 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.