Perio Docs - Lewiston PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PERIO DOCS - LEWISTON PLLC

Practice address

3323 4TH St
Lewiston, ID 83501-4423

Phone

(208) 743-1114

Fax

(208) 743-3029

NPI assigned

Nov 15, 2021

Organization subpart

No

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

Authorized official

Name

Amanda D Aiken

Title

Business Manager

Phone

(509) 326-4445

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• David Wayne Engen, DDS, MSD

  • Periodontics
  • Spokane, WA
  • NPI 1659596948
  NPD (past)
• Andrea Pizzini, DDS

  • Periodontics
  • Spokane, WA
  • NPI 1831708833
  NPD (past)

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1235895160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 N NEVADA ST STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181298",
            "telephone_number": "509-326-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3323 4TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014423",
            "telephone_number": "208-743-1114",
            "fax_number": "208-743-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIO DOCS - LEWISTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "AIKEN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "509-326-4445"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn-Marie Morgan Peashka, PMHNP-BC
• Pebble Creek Dental & Implants PLLC
• Joshua Robert Peregoy, PTA
• William Joseph Perez, D.M.D.
• Performance Physio PLLC (Performance Health and Wellness)
• David A Petersen, MD
• Alan Clifton Peterson, M.D.
• Lisa Peterson, PHARMD
• Mark W Peterson, M.D.
• Carmine John Petracca, OD

• Dental Clinic/Center in Lewiston, ID
• Providers in Lewiston, 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 Nov 22, 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.