Clearwater Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CLEARWATER DENTAL PLLC

Practice address

3161 E Greenhurst Rd
Nampa, ID 83686-8655

Phone

(208) 466-9915

NPI assigned

May 18, 2023

Organization subpart

No

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

Authorized official

Name

Sean Wasden

Title

Coo

Phone

(208) 965-9415

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1215628268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 3RD ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513840",
            "telephone_number": "208-965-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 E GREENHURST RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836868655",
            "telephone_number": "208-466-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "WASDEN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "208-965-9415"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Marie Clark, RDN, LD, CDCES
• Pamela Joan Clausen
• Renee Clausen, LMT
• Paul J Clawson, DDS
• Jonna Clayton
• Alain Murhula Clements
• David H Clements, PA-C
• Mark B Clinger, MD - FAMILY PRACTICE
• Club 32 Dental
• Coached by Cassi LLC

• Dental Clinic/Center in Nampa, ID
• Providers in Nampa, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.