Boise Towne Square Dental

Primary specialty

DentistTaxonomy code 122300000X

License

D4485 Issued in ID

Legal business name

BOISE TOWNE SQUARE DENTAL

Practice address

7677 W. Emerald
Boise, ID 83704

Phone

(208) 639-4390

Fax

(208) 639-4393

NPI assigned

Jun 18, 2013

Last updated

Jun 18, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Lee Olson, DDS

Title

Dr./Owner

Phone

(208) 639-4390

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1346689866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7677 W. EMERALD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-639-4390",
            "fax_number": "208-639-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7677 W. EMERALD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-639-4390",
            "fax_number": "208-639-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE TOWNE SQUARE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DR./OWNER",
        "authorized_official_telephone_number": "208-639-4390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boise State University (Boise State University Public Health Clinic)
• Boise State University
• Boise Therapeutic Massage Center, LLC
• Boise Toothtown Dentistry for Kids PLLC
• Boise Towne Square Dental
• Boise Ultrasound Company LLP
• Boise VA Hospital
• Boise VA Medical Center
• Boise Valley Asthma & Allergy PA (Boise Valley Asthma And Allergy Clinic)
• Boise Valley Chiropractic LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.