Justin Ray Nelson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D-5579 Issued in ID

Practice address

103 W Superior St
Sandpoint, ID 83864-1601

Phone

(208) 263-8514

NPI assigned

Jun 1, 2021

Last updated

Oct 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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.

• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane Valley, WA
  • NPI 1184018954

  Dentist

  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Cheney, WA
  • NPI 1205385465

  Dentist

  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Deer Park, WA
  • NPI 1336368182
  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1386862134
  NPD (past)
• Community Health Association of Spokane

  dba Lewis and Clark Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Clarkston, WA
  • NPI 1427379460

  Dentist

  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1437360344
  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1790050862
  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1841419603
  NPD (past)

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1588230403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W SUPERIOR ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641601",
            "telephone_number": "208-263-8514",
            "fax_number": "208-844-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W SUPERIOR ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641601",
            "telephone_number": "208-263-8514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 E Dalke Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992088112",
            "country_code": "US",
            "telephone_number": "509-444-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JUSTIN",
        "middle_name": "RAY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61164746",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-5579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadine Lewis Counseling, LLC
• Nami Far North Idaho
• Marc L Natoni, DDS
• Megan Neels, LPC, M.ED.
• Richard G Neher, M.D.
• New Horizons Counseling Center
• Tracy Newton, LCSW
• Alina Niculaescu, PA-C
• North Idaho Children's Mental Health, PLLC.
• North Idaho Neurotherapy LLC

• Dentist in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.