Kootenai Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

1984 Issued in MT

Legal business name

KOOTENAI FAMILY DENTISTRY

Practice address

204 E 6TH St
Libby, MT 59923-2052

Phone

(406) 293-4116

Fax

(406) 293-6645

NPI assigned

Jan 6, 2009

Last updated

Jan 6, 2009By 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

Dr. Ronald E. Mendenhall, DDS

Title

Owner

Phone

(406) 293-4116

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1225274756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1379",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599231379",
            "telephone_number": "406-293-4116",
            "fax_number": "406-293-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 6TH ST",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232052",
            "telephone_number": "406-293-4116",
            "fax_number": "406-293-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOTENAI FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "MENDENHALL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-293-4116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "1984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol J. Kelly, MA, LCPC
• Peter Kitts, FNP-C
• Clyde Allen Knecht, MD
• Kirsten A. Koenig, LCPC
• Kootenai Counseling & Consulting
• Kootenai Valley Head Start
• Kootenai Vision Centers PC
• Kristel Montoya LLC
• Waipuilani Kyes, RDH
• Gary Alan Lamey, LCPC

• Dentist in Libby, MT
• Providers in Libby, MT by specialty
• Dentist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.