NPIMap

Organization Active NPI

JHKK Periodontics, PLLC

Doing business as Idaho Perio. Center For Dental Implants and Laser Periodontal Therapy

  • Periodontics
  • Boise, ID
National Provider Identifier
1437728383
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
JHKK PERIODONTICS, PLLC
Doing business as
Idaho Perio. Center For Dental Implants and Laser Periodontal Therapy
Practice address
2273 S Vista Ave Ste 100
Boise, ID 83705-7350
Phone
(208) 377-2777
Fax
(208) 377-3075
NPI assigned
Jun 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Dr. Kip Katseanes, DMD,MSDNPI 1366824484
Title
Partner in Practice/Periodontist
Phone
(843) 530-4854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

2273 S Vista Ave Ste 100
Boise, ID 83705-7350

Mailing address

2273 S Vista Ave Ste 100
Boise, ID 83705-7350
Phone (208) 377-2777

Other names 1

  • Idaho Perio. Center For Dental Implants and Laser Periodontal Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
JHKK Periodontics PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2273 S Vista Ave
Ste 100
Boise, ID 83705
Phone (208) 377-2777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1437728383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2273 S VISTA AVE STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837057350",
            "telephone_number": "208-377-2777",
            "fax_number": "208-377-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 S VISTA AVE STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837057350",
            "telephone_number": "208-377-2777",
            "fax_number": "208-377-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JHKK PERIODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "KATSEANES",
        "authorized_official_first_name": "KIP",
        "authorized_official_title_or_position": "PARTNER IN PRACTICE/PERIODONTIST",
        "authorized_official_telephone_number": "843-530-4854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD,MSD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Perio. Center For Dental Implants and Laser Periodontal Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.