Individual provider Active NPI

Damon Taylor Armstrong, D.D.S.

  • General Practice Dentistry
  • Blackfoot, ID
National Provider Identifier
1164583761
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3540 Issued in ID
Practice address
625 W Pacific St Ste 4
Blackfoot, ID 83221-2034
Phone
(208) 785-3310
Fax
(208) 785-3393
NPI assigned
Dec 13, 2006
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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 3540 ID Primary

Addresses

Primary practice location

625 W Pacific St Ste 4
Blackfoot, ID 83221-2034

Mailing address

625 W Pacific St Ste 4
Blackfoot, ID 83221-2034
Phone (208) 785-3310

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170213001264 ID Order and Referring Only - Other (Non-Physician) 3577846807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3540IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Damon T. Armstrong D.D.S., P.C Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1164583761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W PACIFIC ST STE 4",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832212034",
            "telephone_number": "208-785-3310",
            "fax_number": "208-785-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W PACIFIC ST STE 4",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832212034",
            "telephone_number": "208-785-3310",
            "fax_number": "208-785-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "DAMON",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "3540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

Verify at the official NPI Registry.