East Boise Dental

Primary specialty

DentistTaxonomy code 122300000X

License

D4068 Issued in ID

Legal business name

EAST BOISE DENTAL

Practice address

150 E Boise Ave
Boise, ID 83706-4379

Phone

(208) 368-0500

NPI assigned

Jun 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Todd Broyles, DDS

Title

Owner

Phone

(208) 368-0500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1194010272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E BOISE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064379",
            "telephone_number": "208-368-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E BOISE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064379",
            "telephone_number": "208-368-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BOISE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "BROYLES",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-368-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Early Words Speech & Language Corp
• Allison Rae Early, SLP
• Susan Leigh Earnst, LCPC
• Morgann Eason, DNP, FNP-C, FNP-BC
• East Boise County Medical Clinic
• East to West Family Medicine
• Karen East, MD
• Norman John East, MD
• Easter Seals-Goodwill Northern Rocky Mountain, Inc.
• Easterseals-Goodwill Northern Rocky Mountain, Inc.

• Dentist in Boise, ID
• Providers in Boise, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.