Kyle James Siemen, D.M.D., P.a.

Primary specialty

DentistTaxonomy code 122300000X

License

D3403 Issued in ID

Legal business name

KYLE JAMES SIEMEN, D.M.D., P.A.

Practice address

333 W Cedar St
Pocatello, ID 83201-5045

Phone

(208) 233-6912

Fax

(208) 233-6921

NPI assigned

May 7, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Kyle James Siemen, D.M.DNPI 1952311078

Title

Dentist/President

Phone

(208) 233-6912

Specialties & licenses 2

Addresses

Other names 1

• Sage Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle James Siemen, DMD

  • General Practice Dentistry
  • Pocatello, ID
  • NPI 1952311078
  NPD (past) Authorized official

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1285044529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W CEDAR ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015045",
            "telephone_number": "208-233-6912",
            "fax_number": "208-233-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W CEDAR ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015045",
            "telephone_number": "208-233-6912",
            "fax_number": "208-233-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE JAMES SIEMEN, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "SIEMEN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "208-233-6912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3403",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sage Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirby James Kuehn
• Amanda Sarah Kunz
• Daniel Christopher Kunz, OD
• Taylor Kunz
• Tyler Kunz, DO
• Laboratory Corporation of America
• Laboratory Corporation of America
• Idelia Labra
• Aspyn Lacey
• John Lackey, MD

• Dentist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.