Southway Orthodontics PLLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

D 3069 OR Issued in ID

Legal business name

SOUTHWAY ORTHODONTICS PLLC

Doing business as

Christensen Orthodontics

Practice address

77 Southway Ave
Suite D
Lewiston, ID 83501-2203

Phone

(208) 798-4427

Fax

(208) 743-4807

NPI assigned

Feb 23, 2017

Last updated

Feb 23, 2017By 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. Bret Christensen, DDS, MSNPI 1568568269

Title

Dr

Phone

(208) 791-0428

Specialties & licenses 1

Addresses

Other names 1

• Christensen Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bret Boyle Christensen, DDS MS

  • Dentist
  • Lewiston, ID
  • NPI 1568568269
  NPD (past) Authorized official

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1225577224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SOUTHWAY AVE",
            "address_2": "SUITE D",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012203",
            "telephone_number": "208-798-4427",
            "fax_number": "208-743-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SOUTHWAY AVE",
            "address_2": "SUITE D",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012203",
            "telephone_number": "208-798-4427",
            "fax_number": "208-743-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWAY ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-23",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "BRET",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "208-791-0428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "ID",
            "license": "D 3069 OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christensen Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald S Soloniuk, M.D.
• Randy Lee Sorensen, D.M.D.
• Sound Physicians of Idaho (Sound Physicians)
• Mary Sousa
• Southway Internists PLLC
• David B Souvenir, M.D.
• Connie Spears, FNP
• David A Spencer, MD
• Pamela Spickler, NP
• Kayla Sprenger

• Customized Equipment (DME) in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Customized Equipment (DME) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.