Pearl Dentistry PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D3396 Issued in ID

Legal business name

PEARL DENTISTRY PC

Practice address

4012 Brian Ave
Caldwell, ID 83605-6305

Phone

(208) 459-4312

Fax

(208) 459-9059

NPI assigned

Jun 13, 2008

Organization subpart

No

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

Authorized official

Name

Spencer Lloyd, D.M.D.

Title

President

Phone

(208) 459-4312

Specialties & licenses 1

Addresses

Other names 1

• Spencer J Lloyd DMD Former legal business name

Locations

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355097600000",
    "number": "1154581056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 BRIAN AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056305",
            "telephone_number": "208-459-4312",
            "fax_number": "208-459-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 BRIAN AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056305",
            "telephone_number": "208-459-4312",
            "fax_number": "208-459-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2012-12-10",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-459-4312",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D3396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spencer J Lloyd DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dental Clinic/Center in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.