Organization Active NPI

Level Up Family Dental

  • Dental Clinic/Center
  • Eagle, ID
National Provider Identifier
1558201509
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LEVEL UP FAMILY DENTAL
Practice address
1100 E Riverside Dr
Eagle, ID 83616-7707
Phone
(208) 398-3020
NPI assigned
Mar 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Grason Joseph Hadfield, DMDNPI 1316561392
Title
General Dentist
Phone
(208) 398-3020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1100 E Riverside Dr
Eagle, ID 83616-7707

Mailing address

3157 N Vigo Ave
Star, ID 83669-1066
Phone (208) 870-1778

National Provider Directory

National Provider Directory

Locations

1100 E Riverside Dr
Eagle, ID 83616
Phone (208) 398-3020

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1558201509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 N VIGO AVE",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836691066",
            "telephone_number": "208-870-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E RIVERSIDE DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167707",
            "telephone_number": "208-398-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVEL UP FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "HADFIELD",
        "authorized_official_first_name": "GRASON",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "208-398-3020",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.