Justin D Ward DMD MSD PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D-4510-OR Issued in ID

Legal business name

JUSTIN D WARD DMD MSD PLLC

Practice address

2271 Overland Ave Ste 4
Burley, ID 83318-2957

Phone

(208) 678-3265

NPI assigned

Sep 23, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Justin Ward, D.M.D., M.S.D.NPI 1316388473

Title

Owner

Phone

20867833265

Specialties & licenses 1

Addresses

Other names 1

• River Valley Orthodontics Doing business as

Locations

Practitioners 2

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

• Justin Ward, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Burley, ID
  • NPI 1316388473
  NPD (past) Authorized official
• Dennis J Michaelson, DMD MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Burley, ID
  • NPI 1609958479
  NPD (past)

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1326474206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 OVERLAND AVE STE 4",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 OVERLAND AVE STE 4",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182957",
            "telephone_number": "208-678-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN D WARD DMD MSD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "20867833265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-4510-OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Valley Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph R. Petersen, M.D.
• Joseph R. Petersen, M.D.
• JRT Healthcare, Inc.
• JRT Healthcare, Inc.
• Ellen K Judd, P.A.
• K2Red L.L.C.
• Logan Kay, DMD
• Shane Ryan Kelsey, MS, LPC
• Kevin D. Banner
• Michael P Klett, D.O.

• Orthodontics and Dentofacial Orthopedics Dentistry in Burley, ID
• Providers in Burley, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.