Paul E Blaisdell, DDS
Individual provider Active NPI General Practice Dentistry · Kuna, ID
NPI 1306337100 · NPPES record last updated May 29, 2018
Key facts
- NPI
- 1306337100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D-4925 (ID)
- Practice address
- 1621 N Linder Rd
Kuna, ID 83634-3032 - Phone
- (208) 922-5111
- NPI assigned
- May 29, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4925 | ID | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul E Blaisdell DDS PLLC | Current |
Accepting new patients | |
| Swan Falls Family Dentistry | General Practice | Past | Accepting new patients |
Locations
1621 N Linder Rd
Kuna, ID 83634
Phone (208) 922-5111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4925 | ID | Yes |
Addresses
Primary practice location
1621 N Linder Rd
Kuna, ID 83634-3032
Mailing address
1621 N Linder Rd
Kuna, ID 83634-3032
Phone (208) 922-5111
Other providers in Kuna, ID
- Christopher Daniel Bennett
- Amanda Berbert
- Bestlife Care, Inc
- Riley Grigg Beus
- Trista Billingsley
- Boise Birth Village
- Boise Spine & Orthopedic Bracing, LLC
- Taunya L. Bos
- Andrew Boynton
- Dallas Brady
All providers in Kuna, ID · General Practice Dentistry in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.