NPIMap

Organization Active NPI

Idaho Dental Professionals, P.C.

  • General Practice Dentistry
  • Meridian, ID
National Provider Identifier
1407579477
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
IDAHO DENTAL PROFESSIONALS, P.C.
Practice address
3177 W Milano Dr
Meridian, ID 83646-7290
Phone
(208) 228-7104
NPI assigned
Sep 23, 2022
Organization subpart
Yes
Parent organization
IDAHO DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3177 W Milano Dr
Meridian, ID 83646-7290

Mailing address

3177 W Milano Dr
Meridian, ID 83646-7290
Phone (208) 228-7104

Other names 1

  • Dental Care at Verona Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Idaho Dental Professionals PC9 organizations share this tax ID, including this one
Part of
Idaho Dental Professionals PC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3177 W Milano Dr
Meridian, ID 83646
Phone (208) 228-7093

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1407579477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3177 W MILANO DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467290",
            "telephone_number": "208-228-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3177 W MILANO DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467290",
            "telephone_number": "208-228-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDAHO DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Verona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.