Cornerstone Family & Cosmetic Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

D3826 Issued in ID

Legal business name

CORNERSTONE FAMILY & COSMETIC DENTISTRY

Practice address

143 East Lake Street
McCall, ID 83638

Phone

(208) 634-5255

Fax

(208) 634-1047

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kevin M Elliott, DMD

Title

Partner

Phone

(208) 634-5255

Specialties & licenses 2

Addresses

Other identifiers 5

Tax ID family

Cornerstone Family Cosmetic Dentistry2 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.

• Cornerstone Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Cascade, ID
  • NPI 1962629527
  NPD tax ID

Locations

Practitioners 1

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

• Shane Lee Newton, DMD

  • Dentist
  • McCall, ID
  • NPI 1619049962
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629295274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1496",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "83638",
            "telephone_number": "208-634-5255",
            "fax_number": "208-634-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 EAST LAKE STREET",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "83638",
            "telephone_number": "208-634-5255",
            "fax_number": "208-634-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY & COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "208-634-5255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3826",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1913080",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. NEWTON REGENCE BS",
            "identifier": "000010155075",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR ELLIOTT REGENCE BS",
            "identifier": "00001156002",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. NEWTON BC BS",
            "identifier": "6P003",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR ELLIOTT BC BS",
            "identifier": "6P005",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Childs, LPC
• Deanna Louise Clauson, NBC-HWC, FMCHC
• Brooke Christine Conrad, PT, DPT
• Jesse Cook
• Alena Coons, MA, LPC
• Constance Lillian Crogh, PT
• Cultivating Connection, LLC
• Jonathan M Currey, MD
• Jodi Marie Currie
• Sarah A. Curtin, MD

• All providers in McCall, ID
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.