Rufus O. Van Dyke, D.D.S., M.CL.D

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D-3206-OR Issued in ID

Legal business name

RUFUS O. VAN DYKE, D.D.S., M.CL.D

Practice address

1455 Bench Rd
Suite a
Pocatello, ID 83201-5083

Phone

(208) 237-3330

NPI assigned

Sep 8, 2008

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Van Dyke

Title

Office Manager

Phone

(208) 237-3330

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1487802096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 BENCH RD",
            "address_2": "SUITE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 BENCH RD",
            "address_2": "SUITE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015083",
            "telephone_number": "208-237-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUFUS O. VAN DYKE, D.D.S., M.CL.D",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "VAN DYKE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-237-3330"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-3206-OR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9211318",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle A Roth, NP
• Elizabeth Lassen Rowden, MS, RDN, LD
• Nathan T. Rowe, NP-C
• RSM PA PLLC (Family First Health Centers South)
• Tenille Rudeen, SLP
• Jennifer Ruiz
• Richard Willis Runyan, M.D.
• Yvonne Jo Rupe, LPN
• Nadilyn Michelle Rushton, OTL-2777
• Madison Russell

• Orthodontics and Dentofacial Orthopedics Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.