NPIMap

Organization Active NPI

Stone Ridge Dental P.C.

  • Preferred Provider Organization
  • Blackfoot, ID
National Provider Identifier
1609113455
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
D-4169 Issued in ID
Legal business name
STONE RIDGE DENTAL P.C.
Practice address
380 W Judicial St
Blackfoot, ID 83221-2122
Phone
(208) 785-6833
NPI assigned
Jan 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Dr. Curtis Carpenter, D.D.S.
Title
President
Phone
(208) 357-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X D-4169 ID Primary

Addresses

Primary practice location

380 W Judicial St
Blackfoot, ID 83221-2122

Mailing address

380 W Judicial St
Blackfoot, ID 83221-2122
Phone (208) 785-6833

Other names 1

  • Blackfoot Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stone Ridge Dental PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1609113455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W JUDICIAL ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832212122",
            "telephone_number": "208-785-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W JUDICIAL ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832212122",
            "telephone_number": "208-785-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE RIDGE DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-357-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "ID",
            "license": "D-4169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackfoot Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.