Active NPI
Bruce D.M.D. and Ririe D.D.S., P.a.
Doing business as Boise Integrative Dentistry
- General Practice Dentistry
- Boise, ID
National Provider Identifier
1336340785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D1626
- Legal business name
- BRUCE D.M.D. AND RIRIE D.D.S., P.A.
- Doing business as
- Boise Integrative Dentistry
- Practice address
- 7878 W Ustick Rd
Suite 101
Boise, ID 83704-5006 - Phone
- (208) 376-2920
- Fax
- (208) 376-8509
- NPI assigned
- May 31, 2007
- Last updated
- Sep 21, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- June Alice Juhnke
- Title
- Office Manager
- Phone
- (208) 336-0003
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D1626 | ID | Primary |
Addresses
Primary practice location
7878 W Ustick Rd
Suite 101
Boise, ID 83704-5006
Mailing address
7878 W Ustick Rd
Suite 101
Boise, ID 83704-5006
Phone (208) 376-2920
Other names 1
- Boise Integrative Dentistry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110927000440 | ID | DME Supplier - Oral Surgery - Dentist | 8224209051 | Practice locations: Boise, ID |
National Provider Directory
National Provider DirectoryLocations
7878 W Ustick Rd
#101
Boise, ID 83704
Phone (208) 376-2920
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Boise, ID
- NPI 1164529541
-
- Dentist
- Meridian, ID
- NPI 1053666255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663718400000",
"number": "1336340785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7878 W USTICK RD",
"address_2": "SUITE 101",
"city": "BOISE",
"state": "ID",
"postal_code": "837045006",
"telephone_number": "208-376-2920",
"fax_number": "208-376-8509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7878 W USTICK RD",
"address_2": "SUITE 101",
"city": "BOISE",
"state": "ID",
"postal_code": "837045006",
"telephone_number": "208-376-2920",
"fax_number": "208-376-8509"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRUCE D.M.D. AND RIRIE D.D.S., P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-31",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A",
"authorized_official_last_name": "JUHNKE",
"authorized_official_first_name": "JUNE",
"authorized_official_middle_name": "ALICE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "208-336-0003"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D1626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Boise Integrative Dentistry",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.