NPIMap

Organization Active NPI

R Paul Kelson DDS Ms PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boise, ID
National Provider Identifier
1205913209
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D1561OR Issued in ID
Legal business name
R PAUL KELSON DDS MS PA
Practice address
10497 Garverdale CT
Suite #103
Boise, ID 83704
Phone
(208) 378-1300
Fax
(208) 378-1434
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
R Paul Kelson
Title
DDS Ms PA
Phone
(208) 378-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X D1561OR ID Primary

Addresses

Primary practice location

10497 Garverdale CT
Suite #103
Boise, ID 83704

Mailing address

10497 Garverdale CT
Suite #103
Boise, ID 83704
Phone (208) 378-1300

National Provider Directory

National Provider Directory
Tax ID family
R Paul Kelson DDS Ms Orthodontics PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

10497 W Garverdale Ct
Ste 103
Boise, ID 83704
Phone (208) 378-1300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1205913209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10497 GARVERDALE CT",
            "address_2": "SUITE #103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-378-1300",
            "fax_number": "208-378-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10497 GARVERDALE CT",
            "address_2": "SUITE #103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-378-1300",
            "fax_number": "208-378-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R PAUL KELSON DDS MS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "KELSON",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DDS MS PA",
        "authorized_official_telephone_number": "208-378-1300"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D1561OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 9, 2008; 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.