Justin Perry Rader, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D-4317 Issued in ID

Practice address

1223 N Government Way
Coeur D Alene, ID 83814-3250

Phone

(208) 664-9225

Fax

(208) 667-3699

NPI assigned

Aug 24, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Generations Dental PLLC

  • Dental Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1518875574
  NPD (past)

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1548576879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 N GOVERNMENT WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143250",
            "telephone_number": "208-664-9225",
            "fax_number": "208-667-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 N GOVERNMENT WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143250",
            "telephone_number": "208-664-9225",
            "fax_number": "208-667-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADER",
        "first_name": "JUSTIN",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-24",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor William Quinn, MD
• Timothy Quinn, MD
• Nancy Parris Quisenberry, CRC, COUI
• R. Randy Hopkins M.D. P.a
• Michael Raber
• Radiant Christian Counseling, LLC
• Radiology Associates of North Idaho, PA (Kootenai Imaging)
• Radish Nutrition LLC
• Teresa Marie Ragan, MSN, FNP-C
• Raising Resilience Holistic Mental Wellness Inc

• Dentist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.