Ten Mile Smiles Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4721 Issued in ID

Legal business name

TEN MILE SMILES INC

Practice address

2700 W Cherry LN
Ste 120
Meridian, ID 83642-1500

Phone

(208) 887-9000

Fax

(208) 887-9107

NPI assigned

Jun 20, 2016

Organization subpart

No

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

Authorized official

Name

Warren R Willis, DMD

Title

President

Phone

(208) 887-9000

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Jared Furgeson

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1013924208
  NPD (past)

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1598115644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W CHERRY LN",
            "address_2": "STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421500",
            "telephone_number": "208-887-9000",
            "fax_number": "208-887-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W CHERRY LN",
            "address_2": "STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421500",
            "telephone_number": "208-887-9000",
            "fax_number": "208-887-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEN MILE SMILES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-887-9000",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235336827",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568535011",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Teich, RD, LD
• Corinne Teigen, LMSW
• Lodaicy E Teldeschi
• Telemental Health Link LLC
• Sri Harsha Tella, MBBS
• Ten Mile Surgery Center, LLC
• Aubrie Tenney
• Janessa Tenney, PA-C
• Terrace Home Health Boise LLC
• Terrace Home Health Boise LLC

• General Practice Dentistry in Meridian, ID
• Providers in Meridian, 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 Jun 20, 2016; 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.