Smiles 4 Kids Burley

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

1223P0221X Issued in ID

Legal business name

SMILES 4 KIDS BURLEY

Practice address

1408 Pomerelle Ave
Suite D
Burley, ID 83318-2064

Phone

(208) 734-7415

Fax

(208) 733-1922

NPI assigned

Jan 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Trent Graff Pryor, DMD

Title

Dentist

Phone

(208) 734-7415

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1346510237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E",
            "address_2": "SUITE 1000C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-734-7415",
            "fax_number": "208-733-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 POMERELLE AVE",
            "address_2": "SUITE D",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182064",
            "telephone_number": "208-734-7415",
            "fax_number": "208-733-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES 4 KIDS BURLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "TRENT",
        "authorized_official_middle_name": "GRAFF",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-734-7415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "1223P0221X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Max Serr, D.C.
• Kristi Amber Shanahan, DPT
• Marizza Shoup
• Simply Hope Family Outreach Inc
• Norman D. Sinclair, M.S.
• Daelynn Jo Smith, FNP
• Shaylynn Sherrick Smith, FNP-C
• Smiths Food & Drug Centers Inc (Smiths Pharmacy #123)
• Smithson Counseling LLC (Andy Smithson)
• Robert Andrew Smithson, LMSW

• Pediatric Dentistry in Burley, ID
• Providers in Burley, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.