Dental Care West

Primary specialty

DentistTaxonomy code 122300000X

License

D3522 Issued in ID

Legal business name

DENTAL CARE WEST

Practice address

850 S Latah St
Boise, ID 83705-2255

Phone

(208) 342-7714

Fax

(208) 342-7781

NPI assigned

Jan 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Charles Scott Grace, DDSNPI 1992917207

Title

DDS/ Owner

Phone

(208) 342-7714

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Basic Dental Care Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Scott Grace, D.D.S

  • Dentist
  • Boise, ID
  • NPI 1992917207
  NPD (past) Authorized official

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1508196189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S LATAH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052255",
            "telephone_number": "208-342-7714",
            "fax_number": "208-342-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S LATAH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052255",
            "telephone_number": "208-342-7714",
            "fax_number": "208-342-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DDS/ OWNER",
        "authorized_official_telephone_number": "208-342-7714",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807704900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808491300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Basic Dental Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jennifer K Dennis
• Greg W Dennler
• Susan E Denny, M.S., C.HT.
• Cynthia Evon Dent, BS
• Ronald J Dent, EDD
• Dentistry for Children
• Dentistry One of Idaho PC
• Dentists of Boise and Orthodontics, PC
• Rebecca Lynn Deppen, RN
• Derek Derkacs, PA-C

• Dentist in Boise, ID
• Providers in Boise, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.