Individual provider Active NPI

Steven M. Bruce, D.M.D.

  • General Practice Dentistry
  • Boise, ID
National Provider Identifier
1164529541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D1626 Issued in ID
Practice address
7878 Ustick Road
Suite 101
Boise, ID 83704-5848
Phone
(208) 376-2920
Fax
(208) 376-8509
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D1626 ID Primary

Addresses

Primary practice location

7878 Ustick Road
Suite 101
Boise, ID 83704-5848

Mailing address

7878 Ustick Road
Suite 101
Boise, ID 83704-5848
Phone (208) 376-2920

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
I20150709002231 ID Order and Referring Only - DentistPractitioner - Dentist 8820269665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D1626IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce D.M.D. and Ririe D.D.S., P.a. General Practice PastSince Jul 15, 2011 Accepting new patients

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164529541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7878 USTICK ROAD",
            "address_2": "SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045848",
            "telephone_number": "208-376-2920",
            "fax_number": "208-376-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7878 USTICK ROAD",
            "address_2": "SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045848",
            "telephone_number": "208-376-2920",
            "fax_number": "208-376-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "STEVEN",
        "middle_name": "M.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.