NPIMap

Organization Active NPI

Woodland Family Dental PC

  • General Practice Dentistry
  • Post Falls, ID
National Provider Identifier
1528431665
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D4715 Issued in ID
Legal business name
WOODLAND FAMILY DENTAL PC
Practice address
5082 E Shore CV
Post Falls, ID 83854-6888
Phone
(406) 366-0661
NPI assigned
Nov 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
David Graham Welton, DDS
Title
Ceo
Phone
(406) 366-0661

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D4715 ID Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D4714 ID

Addresses

Primary practice location

5082 E Shore CV
Post Falls, ID 83854-6888

Mailing address

1100 E Polston Ave
Post Falls, ID 83854-6045
Phone (406) 366-0661

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1528431665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "406-366-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5082 E SHORE CV",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546888",
            "telephone_number": "406-366-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "WELTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GRAHAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-366-0661",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4715",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.