Paul E Blaisdell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4925 Issued in ID

Practice address

1621 N Linder Rd
Kuna, ID 83634-3032

Phone

(208) 922-5111

NPI assigned

May 29, 2018

Last updated

May 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Paul E Blaisdell DDS PLLC

  dba Swan Falls Family Dentistry

  • Dental Clinic/Center
  • Kuna, ID
  • NPI 1164210126
  NPD Authorized official
• Swan Falls Family Dentistry

  • General Practice Dentistry
  • Kuna, ID
  • NPI 1710159389
  NPD (past)

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1306337100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 N LINDER RD",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343032",
            "telephone_number": "208-922-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 N LINDER RD",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343032",
            "telephone_number": "208-922-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Daniel Bennett, LCPC, NCC
• Amanda Berbert, MD
• Bestlife Care, Inc (Swan Falls Assisted Living)
• Riley Grigg Beus, OD
• Trista Billingsley, PTA
• Boise Birth Village
• Boise Spine & Orthopedic Bracing, LLC
• Taunya L. Bos, MS, CCC-SLP
• Andrew Boynton, DPT
• Dallas Brady

• General Practice Dentistry in Kuna, ID
• Providers in Kuna, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.