Active NPI
Benjamin Luke Byrd, DDS
- General Practice Dentistry
- Kellogg, ID
National Provider Identifier
1376975458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-4696
- Practice address
- 302 E Cameron Ave
Kellogg, ID 83837-2333 - Phone
- (208) 786-7031
- NPI assigned
- Jul 31, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4696 | ID | Primary |
Addresses
Primary practice location
302 E Cameron Ave
Kellogg, ID 83837-2333
Mailing address
302 E Cameron Ave
Kellogg, ID 83837-2333
Phone (208) 786-7031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4696 | ID | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Filip E Orban DDS PA | Past | Accepting new patients | |
| Byrd Dentistry, PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Kellogg, ID
- NPI 1790155430
-
- Dentist
- Kellogg, ID
- NPI 1346506508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444780800000",
"number": "1376975458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 E CAMERON AVE",
"city": "KELLOGG",
"state": "ID",
"postal_code": "838372333",
"telephone_number": "208-786-7031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 E CAMERON AVE",
"city": "KELLOGG",
"state": "ID",
"postal_code": "838372333",
"telephone_number": "208-786-7031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYRD",
"first_name": "BENJAMIN",
"middle_name": "LUKE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-31",
"last_updated": "2015-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-4696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kellogg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.