Dean A Wallentine, PHARM D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

P5441 Issued in ID

Practice address

836 Washington St
Montpelier, ID 83254-1423

Phone

(208) 847-1421

Fax

(208) 847-1690

NPI assigned

Aug 23, 2005

Last updated

Apr 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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.

• Bear Lake Drug LLC

  • Community/Retail Pharmacy
  • Montpelier, ID
  • NPI 1861806820
  NPD (past)
• Bear Lake Drug Garden City

  • Community/Retail Pharmacy
  • Garden City, UT
  • NPI 1790500171
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1265425433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 WASHINGTON ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541423",
            "telephone_number": "208-847-1421",
            "fax_number": "208-847-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 WASHINGTON ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541423",
            "telephone_number": "208-847-1421",
            "fax_number": "208-847-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENTINE",
        "first_name": "DEAN",
        "middle_name": "A",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "P5441",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5441",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "1440CP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Brinton Stevens, D.C.
• Doris Faye Thornock
• Robert John Timothy, D.D.S.
• Shaun David Tobler, MSW, LCSW
• Valley Home Oxygen
• Kasey L Ward, NP
• Mina L Wayman, GNP
• Whitney Marie Weborg, PT, DPT
• Monty Brett Weston, D.D.S.
• Lynette Dawn Williams, RPH

• Pharmacist in Montpelier, ID
• Providers in Montpelier, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.