North College Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1788 Issued in ID

Legal business name

NORTH COLLEGE DENTAL, PC

Practice address

1411 Fillmore St
Suite 601
Twin Falls, ID 83301-3343

Phone

(208) 734-2300

Fax

(208) 736-7214

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Marni Peterson

Title

Office Manager

Phone

(208) 734-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kenneth E Pattersom, DDS

  • Dentist
  • Twin Falls, ID
  • NPI 1588718746
  NPD (past)

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1336313683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FILLMORE ST",
            "address_2": "SUITE 601",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013343",
            "telephone_number": "208-734-2300",
            "fax_number": "208-736-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 FILLMORE ST",
            "address_2": "SUITE 601",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013343",
            "telephone_number": "208-734-2300",
            "fax_number": "208-736-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COLLEGE DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARNI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-734-2300"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO SMILES",
            "identifier": "9201590",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Evan Norman, M.D.
• Timothy J Norris, M.D.
• North Canyon Medical Center Inc.
• North Canyon Medical Center Inc.
• North Canyon Medical Center, Inc.
• Northland Hearing Centers, Inc.
• Northwest Bec-Corp
• Northwest Bel-Corp
• Northwest Gastroenterology, PLLC
• Nphalanx Home Care LLC

• General Practice Dentistry in Twin Falls, ID
• Providers in Twin Falls, 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 Apr 17, 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.