Ikdo Emmett LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

IKDO EMMETT LLC

Practice address

314 S Washington Ave
Emmett, ID 83617-2952

Phone

(208) 999-4999

NPI assigned

Oct 31, 2019

Last updated

Oct 31, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lorie A Hurst

Title

Bookkeeper

Phone

(208) 283-7634

Specialties & licenses 2

Addresses

Locations

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.

• Jeffrey K Davis, DDS

  • Pediatric Dentistry
  • Boise, ID
  • NPI 1730197849
  NPD (past)

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1194369371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3289 N TOWERBRIDGE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836468347",
            "telephone_number": "208-884-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172952",
            "telephone_number": "208-999-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IKDO EMMETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "LORIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "208-283-7634"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason L Howard, O.D.
• Rebecca Lynne Hudson, MA,LPC
• Idaho Behavioral Health, Inc. (Idaho Behavioral Health Emmett)
• Idaho Dental Professionals, P.C. (Quail Run Dental Care)
• Idaho Priority Prescriptions
• Independent School District of Emmett #221
• Kenneth Roy Inselman, R.PH
• Lisa Isaksen, NP-C, PMHNP-BC
• Jeffrey L Henken DDS
• Juliette Jennings

• Pediatric Dentistry in Emmett, ID
• Providers in Emmett, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.