Individual provider Active NPI

Patrick A Niland, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Nampa, ID
National Provider Identifier
1154427979
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D3235OR Issued in ID
Practice address
1609 12TH Ave Rd
Nampa, ID 83686-6102
Phone
(208) 467-5259
Fax
(208) 466-3741
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D3235OR ID Primary

Addresses

Primary practice location

1609 12TH Ave Rd
Nampa, ID 83686-6102

Mailing address

1609 12TH Ave Rd
Nampa, ID 83686-6102
Phone (208) 467-5259

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150819007907 ID Order and Referring Only - DentistPractitioner - Dentist 0840505863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D3235ORIDMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Plumtree Orthodontics PLLC PastSince Jan 28, 2024 Accepting new patients
Nampa Caldwell Orthodontics Orthodontics and Dentofacial Orthopedics 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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1154427979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866102",
            "telephone_number": "208-467-5259",
            "fax_number": "208-466-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866102",
            "telephone_number": "208-467-5259",
            "fax_number": "208-466-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILAND",
        "first_name": "PATRICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D3235OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.