Four Season Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1967 Issued in ID

Legal business name

FOUR SEASON DENTAL PC

Practice address

115 E Chapel Rd
Pocatello, ID 83201

Phone

(208) 237-6848

Fax

(208) 237-6811

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Liz John

Title

Office Manager

Phone

(208) 237-6848

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.

• Reed Kim Smith, DDS

  • General Practice Dentistry
  • Pocatello, ID
  • NPI 1760566384
  NPD (past)

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1215102439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E CHAPEL RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-237-6848",
            "fax_number": "208-237-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E CHAPEL RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-237-6848",
            "fax_number": "208-237-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASON DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-237-6848"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1967",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya R Forsman, MC
• Foster Investments LLC
• Jacob R Foster, PA-C
• Madeline Claire Foster, PHARMD
• Four Pillars Nutrition and Wellness, LLC
• Tammy Sue Fouse, DO
• Cindy Fowler, MS
• Randall Fowler, MD
• Stephen C. Fox, BS
• David Lee Francis, MD

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.