Smiles 4 Kids Blackfoot PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SMILES 4 KIDS BLACKFOOT PLLC

Practice address

621 Jensen Grove Dr
Blackfoot, ID 83221-1685

Phone

(208) 785-4696

NPI assigned

Sep 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kory D Bingham, D.D.S.

Title

Managing Partner

Phone

(208) 529-3007

Specialties & licenses 1

Addresses

Other names 1

• Smiles 4 Kids Doing business as

Locations

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1154799047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 JENSEN GROVE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211685",
            "telephone_number": "208-785-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 JENSEN GROVE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211685",
            "telephone_number": "208-785-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES 4 KIDS BLACKFOOT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "KORY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "208-529-3007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles 4 Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Simpson Chiropractic PLLC
• Simpson Dental Offices
• Charles Gordon Simpson, DDS
• Preston Oliver Simpson, DC
• Troy Gordon Simpson, DDS
• Bo Robert Smith
• Dekker Smith, PT, DPT
• Lucas Smith
• Scott Delane Smith, D.C.
• Maryann Smout, DNP, FNP-C

• Pediatric Dentistry in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.