Summit Dental Care Paul, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

D4743 Issued in ID

Legal business name

SUMMIT DENTAL CARE PAUL, PLLC

Practice address

207 W Ellis Street
Paul, ID 83347

Phone

(208) 438-4855

Fax

(208) 438-4835

NPI assigned

Feb 21, 2017

Last updated

Feb 21, 2017By 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

Alisa Frame, FAADOM

Title

Office Manager

Phone

(208) 733-9999

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyle B Christensen, DDS

  • General Practice Dentistry
  • Twin Falls, ID
  • NPI 1134477623
  NPD (past)
• Bryce Christofer Killian, D.D.S.

  • General Practice Dentistry
  • Paul, ID
  • NPI 1609971928
  NPD (past)

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1346789534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "PAUL",
            "state": "ID",
            "postal_code": "833470549",
            "telephone_number": "208-438-4855",
            "fax_number": "208-438-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W ELLIS STREET",
            "city": "PAUL",
            "state": "ID",
            "postal_code": "83347",
            "telephone_number": "208-438-4855",
            "fax_number": "208-438-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL CARE PAUL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "FRAME",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-733-9999",
        "authorized_official_credential": "FAADOM"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce Christofer Killian, D.D.S.
• Jerad H Knight, FNP-C
• Shanna L Lindsay, LPC
• Tara Rayvonti, CPSS. B.S. FPSS
• Nikki Nelson Sayer, LPC
• Together We Thrive LLC
• West Dawn LLC (Riverbend Eye Care)
• West End Fire Protection Dist
• Dianna Zunino, RD, LD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.