Your Special Smiles PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4533 Issued in ID

Legal business name

YOUR SPECIAL SMILES PLLC

Practice address

905 Shoshone St N
Twin Falls, ID 83301-6363

Phone

(208) 859-8449

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Brooke Marie-Osgood Fukuoka, DMD

Title

Owner

Phone

(208) 859-8449

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1467820068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833380195",
            "telephone_number": "208-859-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SHOSHONE ST N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016363",
            "telephone_number": "208-859-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR SPECIAL SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "FUKUOKA",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "MARIE-OSGOOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-859-8449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "4533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Jan Yingst, PT
• Benjamin A Yoder, DPT
• Stephanie Ann York, FNP
• Dallin C Young, D.D.S.
• Your Fit Fork
• Jennifer Ryan Zaccone, MD,LPC
• Michael Zammit, M.D.
• Nevada F Zamora, LMSW
• Glenn D Zausmer, DO
• Brooke Marie Zavala, DC

• Dental Clinic/Center in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.