NPIMap

Organization Active NPI

Coeur D Alene Denture Clinic

Doing business as Teethmakers DBA CDA Denture Clinic

  • Denturist
  • Coeur d'Alene, ID
National Provider Identifier
1558406405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
License
LD42 Issued in ID
Legal business name
COEUR D ALENE DENTURE CLINIC
Doing business as
Teethmakers DBA CDA Denture Clinic
Practice address
1119 N 4TH St
Coeur D Alene, ID 83814
Phone
(208) 667-8997
Fax
(208) 666-1746
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jacqueline Kay Neff, LD43NPI 1184870107
Title
Denturist Co Owner
Phone
(208) 667-8997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DenturistGroup: 193200000X MULTI-SPECIALTY GROUP 122400000X LD42 ID Primary
DenturistGroup: 193200000X MULTI-SPECIALTY GROUP 122400000X LD43 ID

Addresses

Primary practice location

1119 N 4TH St
Coeur D Alene, ID 83814

Mailing address

1119 N 4TH St
Coeur D Alene, ID 83814
Phone (208) 667-8997

Other names 1

  • Teethmakers DBA CDA Denture Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558406405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-8997",
            "fax_number": "208-666-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-8997",
            "fax_number": "208-666-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COEUR D ALENE DENTURE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEFF",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "DENTURIST CO OWNER",
        "authorized_official_telephone_number": "208-667-8997",
        "authorized_official_credential": "LD43"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Denturist",
            "state": "ID",
            "license": "LD42",
            "primary": true
        },
        {
            "code": "122400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Denturist",
            "state": "ID",
            "license": "LD43",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teethmakers DBA CDA Denture Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.