NPIMap

Organization Active NPI

Damon a. Anderson DDS, PC

  • Dental Clinic/Center
  • Boise, ID
National Provider Identifier
1295991669
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D-3787 Issued in ID
Legal business name
DAMON A. ANDERSON DDS, PC
Practice address
2455 N Milwaukee St
Boise, ID 83704-5736
Phone
(208) 376-2721
Fax
(208) 376-2756
NPI assigned
Aug 5, 2008
Last updated
Aug 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Dr. Damon Ashley Anderson, D.D.S.
Title
Owner
Phone
(208) 376-2721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D-3787 ID Primary

Addresses

Primary practice location

2455 N Milwaukee St
Boise, ID 83704-5736

Mailing address

PO Box 80547666
Sioux Falls, SD 57186-0001
Phone (208) 371-2086

National Provider Directory

National Provider Directory
Tax ID family
Damon a Anderson DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2455 N Milwaukee St
Boise, ID 83704
Phone (208) 376-2721

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1295991669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80547666",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571860001",
            "telephone_number": "208-371-2086",
            "fax_number": "208-376-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045736",
            "telephone_number": "208-376-2721",
            "fax_number": "208-376-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMON A. ANDERSON DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-376-2721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-3787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 5, 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.