Magic Valley Dental Anesthesia PLLC

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

Legal business name

MAGIC VALLEY DENTAL ANESTHESIA PLLC

Doing business as

Magic Valley Dental Anesthesia PLLC

Practice address

1411 Falls Ave E Ste 1000C
Twin Falls, ID 83301-3459

Phone

(208) 734-7415

NPI assigned

May 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Judd, DMDNPI 1609946078

Title

Owner

Phone

(503) 679-9797

Specialties & licenses 2

Addresses

Other names 1

• Magic Valley Dental Anesthesia PLLC Doing business as

Practitioners 1

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.

• Ryan W Judd, DMD

  • Dental Anesthesiology
  • Eagle, ID
  • NPI 1609946078
  NPD Authorized official

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1346824422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 S BRANDENBERG AVE",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 1000C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013459",
            "telephone_number": "208-734-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC VALLEY DENTAL ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-679-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magic Valley Dental Anesthesia PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Camille C. Magalogo, LCSW, RPT-S
• Kristen Magalogo
• Eva Azucena Magana, LMSW
• Magic Valley Anesthesiology Associates
• Magic Valley Behavioral Health PLLC
• Magic Valley Denture Center Inc
• Magic Valley Family Practice, PLLC
• Magic Valley Foot and Ankle Specialists PLLC (Caleb Edwin Roberts Sole Mbr)
• Magic Valley Kidney Institute LLP
• Magic Valley Medicine PLLC

• Dental Anesthesiology in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Dental Anesthesiology in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.