James Garl Drake, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-3723 Issued in ID

Practice address

1088 N Skyline Dr
Idaho Falls, ID 83402-1726

Phone

(208) 524-0870

Fax

(208) 524-0873

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grin PLLC

  • General Practice Dentistry
  • Idaho Falls, ID
  • NPI 1144720103
  NPD (past) Authorized official
• Parkwest Dental Care

  • Dental Clinic/Center
  • Idaho Falls, ID
  • NPI 1861666745
  NPD

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1164589982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 PANCHERI DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023344",
            "telephone_number": "208-524-0870",
            "fax_number": "208-524-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 N SKYLINE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021726",
            "telephone_number": "208-524-0870",
            "fax_number": "208-524-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "JAMES",
        "middle_name": "GARL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806768500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley L Doyle
• Dpmcallnrid LLC
• Dr Mark D Denney OD PA
• Dr. Facer Psychiatry PLLC
• Dr. James D. Tanner, D.C., P.a.
• Trevor Lee Drake, CRNA, MHS
• Dreamworks Anesthesia PC
• Aaron Scott Drees, CRNA, DNAP, RN
• James G Drewett, PHARM.D., PH.D.
• DSM Optometry LLC

• General Practice Dentistry in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.