Downtown Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3689 Issued in ID

Legal business name

DOWNTOWN DENTAL PLLC

Practice address

1625 W Bannock Street
Boise, ID 83702-5155

Phone

(208) 342-5444

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Michael Kowalczyk, DENTIST

Title

Owner/Manager

Phone

(208) 342-5444

Specialties & licenses 1

Addresses

Tax ID family

Downtown Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Downtown Dental

  • General Practice Dentistry
  • Boise, ID
  • NPI 1073805735
  NPD tax ID

Locations

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1629237540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025155",
            "telephone_number": "208-342-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W BANNOCK STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025155",
            "telephone_number": "208-342-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "208-342-5444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Dowen
• Michael I Downey, D.C.
• Sara Downey
• Downtown Dental
• Downtown Dental PLLC
• Nathan Stephen Doyel Jr., DO
• James Thomas Doyle, MD
• Katelyn Doyle, OD
• Margaret Ellen Doyle, LCSW
• Megan Doyle, OTR/L

• General Practice Dentistry in Boise, ID
• Providers in Boise, 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 5, 2008; 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.