Organization Active NPI

Kent Cutforth DDS

  • Dentist
  • Idaho Falls, ID
National Provider Identifier
1376876110
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KENT CUTFORTH DDS
Practice address
1370 E. 17TH Street
Idaho Falls, ID 83404
Phone
(208) 523-3388
Fax
(208) 535-0995
NPI assigned
Sep 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Authorized official

Name
Dr. Bert Kent Cutforth, D.D.S.
Title
Dentist/Owner
Phone
(208) 523-3388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1370 E. 17TH Street
Idaho Falls, ID 83404

Mailing address

1370 E. 17TH Street
Idaho Falls, ID 83404
Phone (208) 523-3388

Other identifiers 2

IdentifierTypeStateIssuer
001169300MedicaidID
808413300MedicaidID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1376876110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 E. 17TH STREET",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-523-3388",
            "fax_number": "208-535-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 E. 17TH STREET",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-523-3388",
            "fax_number": "208-535-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT CUTFORTH DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "CUTFORTH",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "208-523-3388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001169300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808413300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.