NPIMap

Organization Active NPI

JHKK Periodontics, PLLC

Doing business as Idaho Perio

  • Periodontics
  • Boise, ID
National Provider Identifier
1184399214
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
JHKK PERIODONTICS, PLLC
Doing business as
Idaho Perio
Practice address
6019 N Eagle Rd
Boise, ID 83713-0997
Phone
(208) 377-2777
Fax
(208) 377-3075
NPI assigned
Aug 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Authorized official

Name
Dr. Kip Katseanes, DMD, MSD
Title
Partner in Practice/Perodontist
Phone
(843) 530-4854

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

6019 N Eagle Rd
Boise, ID 83713-0997

Mailing address

6019 N Eagle Rd
Boise, ID 83713-0997
Phone (208) 377-2777

Other names 1

  • Idaho Perio Doing business as

National Provider Directory

National Provider Directory
Tax ID family
JHKK Periodontics PLLC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1184399214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6019 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130997",
            "telephone_number": "208-377-2777",
            "fax_number": "208-377-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130997",
            "telephone_number": "208-377-2777",
            "fax_number": "208-377-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JHKK PERIODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "KATSEANES",
        "authorized_official_first_name": "KIP",
        "authorized_official_title_or_position": "PARTNER IN PRACTICE/PERODONTIST",
        "authorized_official_telephone_number": "843-530-4854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MSD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Perio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.