Idaho Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D3936 Issued in ID

Legal business name

IDAHO PEDIATRIC DENTISTRY

Practice address

4401 E Flamingo Ave
Nampa, ID 83687-3113

Phone

(208) 461-5459

Fax

(208) 461-6023

NPI assigned

Dec 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Christopher K Loveland, DDS

Title

Owner

Phone

(208) 461-5459

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Idaho Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Idaho Pediatric Dentistry

  • Special Hospital
  • Nampa, ID
  • NPI 1659530103
  NPD tax ID

Locations

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1467697177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 E FLAMINGO AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873113",
            "telephone_number": "208-461-5459",
            "fax_number": "208-461-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 E FLAMINGO AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873113",
            "telephone_number": "208-461-5459",
            "fax_number": "208-461-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "LOVELAND",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-461-5459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D3936",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D3908",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807511400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808185200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Eye Pros of Nampa
• Idaho Family Physical Therapy PLLC
• Idaho Medical Products
• Idaho Medical Products
• Idaho Mental Wellness & Addiction Recovery PLLC
• Idaho Pediatric Dentistry
• Idaho Physical Therapy Inc.
• Idaho Physicians Eyecare Group, P.C.
• Idaho Sleep Services, LLC
• Idaho Sleep Solutions, LLC

• Pediatric Dentistry in Nampa, ID
• Providers in Nampa, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.