Active NPI
Jake Dabell Dental Boise PLLC
- Dental Clinic/Center
- Boise, ID
National Provider Identifier
1255055661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- JAKE DABELL DENTAL BOISE PLLC
- Practice address
- 9502 W Fairview Ave
Boise, ID 83704-8103 - Phone
- (208) 377-2223
- NPI assigned
- Sep 29, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Frank
- Title
- Insurance Coordinator
- Phone
- (509) 570-6879
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
9502 W Fairview Ave
Boise, ID 83704-8103
Mailing address
9502 W Fairview Ave
Boise, ID 83704-8103
Phone (208) 377-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 261QD0000X | Other | ID | TAXONOMY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | insurance.wvnd@gmail.com | Direct |
National Provider Directory
National Provider Directory- Tax ID family
- Jake Dabell Dental Boise PLLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba West Valley Natural Dentistry
- Dental Clinic/Center
- Boise, ID
- NPI 1932832789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664409600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671408000000",
"number": "1255055661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9502 W FAIRVIEW AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837048103",
"telephone_number": "208-377-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9502 W FAIRVIEW AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837048103",
"telephone_number": "208-377-2223"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JAKE DABELL DENTAL BOISE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-29",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A",
"authorized_official_last_name": "FRANK",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "INSURANCE COORDINATOR",
"authorized_official_telephone_number": "509-570-6879"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY",
"identifier": "261QD0000X",
"state": "ID"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "insurance.wvnd@gmail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9502 W Fairview Ave",
"city": "Boise",
"state": "ID",
"country_code": "US",
"postal_code": "837048103",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.