Alexis Phillips, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D-5002-PD Issued in ID

Practice address

136 E Mallard Dr
Boise, ID 83706-3975

Phone

(208) 500-5437

Fax

(208) 908-6178

NPI assigned

Mar 24, 2017

Last updated

Mar 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Boise Children's Dentistry PLLC

  dba Dr. Alexis Phillips Kids Dentist

  • Pediatric Dentistry
  • Boise, ID
  • NPI 1700503133
  NPD

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1346771904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NATIONAL DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972079",
            "telephone_number": "770-856-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E MALLARD DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063975",
            "telephone_number": "208-500-5437",
            "fax_number": "208-908-6178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave",
            "address_2": "Cincinnati Children's Hospital Medical Center",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45229",
            "country_code": "US",
            "telephone_number": "770-856-1308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ALEXIS",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D-5002-PD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO",
            "identifier": "1346771904",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346771904",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smile@boisechildrens.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "136 E Mallard Dr",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837063975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pharmacy Solutions, Inc.
• Pharmerica Drug Systems Inc (Pharmerica)
• Mark Aaron Phelan, RN
• Sarah Harley Phelan, DNP
• Philip D Jensen MD Chartered
• Andrew Phillips
• Bradley Phillips, MD
• Charissa May Phillips, RN
• Darlene Phillips, LCPC
• David Phillips

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.