Kimberly Nealy, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-5230 Issued in ID

Practice address

1675 W Hill Rd
Boise, ID 83702-0982

Phone

(208) 342-3695

NPI assigned

May 8, 2015

Last updated

May 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kimberly Malotky Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Steven G. Johnson Dental Corporation

  • General Practice Dentistry
  • Santa Barbara, CA
  • NPI 1285143495
  NPD (past)
• Steven G. Johnson Dental Corporation

  dba Johnson Family Dental

  • General Practice Dentistry
  • Ventura, CA
  • NPI 1457761983
  NPD (past)

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1225416423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 W HILL RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837020982",
            "telephone_number": "208-342-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W HILL RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837020982",
            "telephone_number": "208-342-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEALY",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MALOTKY",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claudius Ndifon Ndigamkong
• Ben A Ndisanze
• Jared Neal, AT
• Matthew D Neale, MD
• Jason Nealy, D.O.
• Joanne Nearman, LCPC
• Kaitlin C Neary, M.D.
• Danielle Nebeker, R.D., L.D.
• Trudy Nebeker
• Alejandro J Necochea, MD

• General Practice Dentistry in Boise, ID
• Providers in Boise, 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 May 25, 2021; 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.