J Macmillan Bruce DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

D3713 Issued in ID

Legal business name

J MACMILLAN BRUCE DDS INC

Practice address

1744 N Mitchell St
Boise, ID 83704

Phone

(208) 323-7999

Fax

(208) 322-5662

NPI assigned

May 14, 2008

Organization subpart

No

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

Authorized official

Name

Rachael K Bruce

Title

Office Manager

Phone

(208) 323-7999

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1295902724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 N MITCHELL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-323-7999",
            "fax_number": "208-322-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 N MITCHELL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-323-7999",
            "fax_number": "208-322-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J MACMILLAN BRUCE DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-323-7999"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806659200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Boise, ID
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.