NPIMap

Organization Active NPI

Mountain View Dentistry

  • General Practice Dentistry
  • Grangeville, ID
National Provider Identifier
1295994408
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3987 Issued in ID
Legal business name
MOUNTAIN VIEW DENTISTRY
Practice address
615 W North St
Grangeville, ID 83530-1239
Phone
(208) 983-0105
Fax
(208) 983-2339
NPI assigned
Jun 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Mrs. Ashlee Behler
Title
Secretary
Phone
(208) 983-0105

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D3987 ID Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D3978 ID

Addresses

Primary practice location

615 W North St
Grangeville, ID 83530-1239

Mailing address

615 W North St
Grangeville, ID 83530-1239
Phone (208) 983-0105

Other identifiers 2

IdentifierTypeStateIssuer
807500900MedicaidID
807665400MedicaidID

National Provider Directory

National Provider Directory

Locations

615 W North St
Grangeville, ID 83530
Phone (208) 983-0105

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1295994408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W NORTH ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301239",
            "telephone_number": "208-983-0105",
            "fax_number": "208-983-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W NORTH ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301239",
            "telephone_number": "208-983-0105",
            "fax_number": "208-983-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "BEHLER",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-983-0105",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3987",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807500900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807665400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grangeville, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.