Jack H Lincks, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D-3947-PE Issued in ID

Practice address

140 E Boise Ave
Boise, ID 83706-4373

Phone

(208) 385-9228

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Periodontal Health Specialists of Idaho

  • Periodontics
  • Boise, ID
  • NPI 1689077026
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346224458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 OREGON TRAIL PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837165657",
            "telephone_number": "808-783-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E BOISE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064373",
            "telephone_number": "208-385-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCKS",
        "first_name": "JACK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "4199",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ID",
            "license": "D-3947-PE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Liming, M.S., CCC-SLP
• Jeffrey Heng-Yi Lin, MD
• Vanessa Lin, DO
• Lanae Esther Linard
• Lincare Inc.
• Lincoln Counseling LLC
• Caroline Lincoln, LPC
• Gwen Aileen Lindberg, PA-C
• Noble L Lindberg III, NOBLE LINDBERG
• Suzannah Lindberg

• Periodontics in Boise, ID
• Providers in Boise, ID by specialty
• Periodontics in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.