Nathan Richard George, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4352 Issued in ID

Practice address

7726 Lupine Lane
Victor, ID 83455

Phone

(208) 787-8100

NPI assigned

Apr 25, 2011

Sex

Male

Sole proprietor

Yes

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.

• Mountain River Dental

  • Dental Clinic/Center
  • Victor, ID
  • NPI 1912136433
  NPD (past)
• Mountain River Dental PLLC

  • Dentist
  • Victor, ID
  • NPI 1093147696
  NPD (past)
• Mountain River Dental PLLC

  • General Practice Dentistry
  • Victor, ID
  • NPI 1366543563

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 25, 2011.

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1437440591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834550487",
            "telephone_number": "208-787-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7726 LUPINE LANE",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "83455",
            "telephone_number": "208-787-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "NATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Childs Play, LLC
• Ann Katherine Cowley, PT
• James K Davis, DC
• Devin Delaney, NTP, RWP
• Sidney Fleecs, S, OTR/L
• Grand Teton Dental Care
• Kimberly Richardson Gutierrez, M.A., CCC/SLP
• Olivia Handyside, SLP
• Happy to Help Caregiving
• Carlen Williams Hervig, M.S. CCC-SLP

• All providers in Victor, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.

Verify at the official NPI Registry.