Braden M. Stauts DDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D-2083-PR Issued in ID

Legal business name

BRADEN M. STAUTS DDS LLC

Practice address

1000 N Curtis Rd
Suite 203
Boise, ID 83706-1337

Phone

(208) 376-0567

NPI assigned

Nov 24, 2008

Organization subpart

No

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

Authorized official

Name

Braden M Stauts, DDS

Title

Owner

Phone

(208) 376-0567

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Braden Stauts DDS Former legal business name

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1386899987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N CURTIS RD",
            "address_2": "SUITE 203",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061337",
            "telephone_number": "208-376-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N CURTIS RD",
            "address_2": "SUITE 203",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061337",
            "telephone_number": "208-376-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADEN M. STAUTS DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "STAUTS",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-376-0567",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-2083-PR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1578588364",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braden Stauts DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Danielle Brachman, DPT
• Tess Brackett, DPT
• Aaron W Brackney, D.O.
• Cali J Bradberry, PA-C
• Zachary Braddock, PT, DPT
• Velma Susan Bradford, M.D.
• Dana Bradley, LCPC
• Jenna Marie Bradley, AU.D.
• Jenni L. Bradley, MD
• Joshua Bradley, ATC

• All providers in Boise, ID
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.

Verify at the official NPI Registry.