NPIMap

Individual provider Active NPI

Jayson Anders Bird, DDS

  • Dentist
  • Pinehurst, ID
National Provider Identifier
1629416151
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D4491 Issued in ID
Practice address
8 N Division St
Pinehurst, ID 83850
Phone
(208) 680-5144
NPI assigned
Jun 6, 2013
Last updated
May 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D4491 ID Primary

Addresses

Primary practice location

8 N Division St
Pinehurst, ID 83850

Mailing address

418 W Cameron Ave
Kellogg, ID 83837-2111
Phone (208) 682-4540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531000629 ID Order and Referring Only - DentistPractitioner - Dentist 1951691120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4491IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
E.T. Dental LLC PastSince Sep 13, 2020 Accepting new patients
Michael J Claymore DDS Dentist Past Accepting new patients
Rainbow Dental Clinic LLC Past Accepting new patients
Bird Family Dental, PLLC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1629416151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 W CAMERON AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372111",
            "telephone_number": "208-682-4540",
            "fax_number": "208-783-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N DIVISION ST",
            "city": "PINEHURST",
            "state": "ID",
            "postal_code": "83850",
            "telephone_number": "208-680-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "JAYSON",
        "middle_name": "ANDERS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, ID

Sources for this page

Verify at the official NPI Registry.