Active NPI
Douglas Frank Pfister, ASLD
- Denturist
- Idaho Falls, ID
National Provider Identifier
1386829562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- LD19
- Practice address
- 554 4TH Street
Idaho Falls, ID 83401 - Phone
- (208) 523-2380
- Fax
- (208) 523-2380
- NPI assigned
- Jan 7, 2008
- 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 |
|---|---|---|---|---|
| Denturist | 122400000X | LD19 | ID | Primary |
Addresses
Primary practice location
554 4TH Street
Idaho Falls, ID 83401
Mailing address
554 4TH Street
Idaho Falls, ID 83401
Phone (208) 523-2380
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 |
|---|---|---|---|
| LD19 | ID | MD | Denturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1386829562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "554 4TH STREET",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83401",
"telephone_number": "208-523-2380",
"fax_number": "208-523-2380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 4TH STREET",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83401",
"telephone_number": "208-523-2380",
"fax_number": "208-523-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFISTER",
"first_name": "DOUGLAS",
"middle_name": "FRANK",
"credential": "ASLD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-07",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "ID",
"license": "LD19",
"primary": true
}
],
"identifiers": [],
"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 Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.