John D Coburn, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4188 Issued in ID

Practice address

700 W Ironwood Dr
Ste 241
Coeur D Alene, ID 83814-2656

Phone

(208) 664-4831

Fax

(208) 666-1804

NPI assigned

Aug 16, 2007

Last updated

Apr 29, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Ideal Family Dentistry

  • Dental Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1548687072
  NPD (past) Authorized official
• Ideal Family Dental

  • General Practice Dentistry
  • Coeur d'Alene, ID
  • NPI 1821634494
  NPD (past)

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1568654150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "STE 241",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-664-4831",
            "fax_number": "208-666-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "STE 241",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-664-4831",
            "fax_number": "208-666-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhett Cline, DPT
• Clinic 5C Dermatology
• Clinic 5C Wound Care
• Stephanie Coates, LMSW
• Jacob Allen Cobb, LMSW
• Whitney Kay Cochran, LMSW
• Coeur D Alene Dental Center
• Coeur D Alene Denture Clinic (Teethmakers DBA CDA Denture Clinic)
• Coeur D Alene Family Dentisrty
• Coeur D Alene Homes Phase II (Orchard Ridge Assisted Living)

• General Practice Dentistry in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.