Active NPI
John H Osterkamp, DDS
- Dentist
- Buhl, ID
National Provider Identifier
1417060633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D3004
- Practice address
- 709 Fair St
Buhl, ID 83316-6442 - Phone
- (208) 543-8907
- Fax
- (208) 543-6190
- NPI assigned
- Aug 15, 2006
- Last updated
- Feb 29, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D3004 | ID | Primary |
Addresses
Primary practice location
709 Fair St
Buhl, ID 83316-6442
Mailing address
709 Fair Ave
Buhe, ID 83316
Phone (208) 543-8907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122002024 | CA | Order and Referring Only - Dentist | 5395048466 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D3004 | ID | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709164800000",
"number": "1417060633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 FAIR AVE",
"city": "BUHE",
"state": "ID",
"postal_code": "83316",
"telephone_number": "208-543-8907",
"fax_number": "208-543-6190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 FAIR ST",
"city": "BUHL",
"state": "ID",
"postal_code": "833166442",
"telephone_number": "208-543-8907",
"fax_number": "208-543-6190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSTERKAMP",
"first_name": "JOHN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2024-02-29",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D3004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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- Shaylyn Garn Richards, PHARMD
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.