Active NPI
Nathan Gardner
- Dentist
- Nampa, ID
National Provider Identifier
1346092624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-5624
- Practice address
- 2065 12TH Ave Rd
Nampa, ID 83686-6311 - Phone
- (208) 466-3239
- NPI assigned
- Apr 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-5624 | ID | Primary |
Addresses
Primary practice location
2065 12TH Ave Rd
Nampa, ID 83686-6311
Mailing address
136 Arbor CT
Omaha, NE 68108-1725
Phone (208) 501-3901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-5624 | ID | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gardner Dental LLC | Dentist | Current | Accepting new patients |
| Scott R Gardner DDS PC | Dentist | Past | Accepting new patients |
Locations
2065 12th Ave Rd
Nampa, ID 83686
Phone (208) 466-3239
Organizations & group practices 2
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.
-
- Dentist
- Nampa, ID
- NPI 1114187598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1346092624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 ARBOR CT",
"city": "OMAHA",
"state": "NE",
"postal_code": "681081725",
"telephone_number": "208-501-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2065 12TH AVE RD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866311",
"telephone_number": "208-466-3239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "NATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-02",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-5624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.