NPIMap

Organization Active NPI

Two Rivers Family & Cosmetic Dentistry, PA

  • Dental Clinic/Center
  • Orofino, ID
National Provider Identifier
1184386336
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA
Practice address
636 Michigan Ave
Orofino, ID 83544
Phone
(208) 476-4917
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Claudette Kim Meyer
Title
Office Manager
Phone
(208) 634-5255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

636 Michigan Ave
Orofino, ID 83544

Mailing address

307 E Park St Ste 103
McCall, ID 83638-3863
Phone (208) 634-5255

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL tworiversdentist.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Family Cosmetic Dentistry PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1184386336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E PARK ST STE 103",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836383863",
            "telephone_number": "208-634-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 MICHIGAN AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "83544",
            "telephone_number": "208-476-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-634-5255"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tworiversdentist.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "636 Michigan Ave",
            "city": "Orofino",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orofino, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.