HD Boise Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HD BOISE DENTAL, LLC

Practice address

1212 N Cole Rd
Boise, ID 83704-8646

Phone

(208) 375-4253

NPI assigned

Mar 23, 2015

Organization subpart

No

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

Authorized official

Name

Chayse Myers

Title

Manager

Phone

(208) 375-4253

Specialties & licenses 1

Addresses

Other names 1

• Half Dental Doing business as

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1346634870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048646",
            "telephone_number": "208-375-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HD BOISE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-23",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "CHAYSE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-375-4253"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Half Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anja Haynes, FNP-C
• Joan Lorraine Haynes, NMD
• Tammie Haynes, BA
• Derek D Hayton, DO
• Alexandria Jordan Hazelgrove, NP
• Rebecca E Headley, LCSW
• William Headley, LMSW
• Willam Heady, CRNA
• Teresa Anne Heald, LMSW
• Dori A Healey, CNS

• All providers in Boise, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; 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.