Idaho Dental Anesthesia PLLC

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

D-4613 Issued in ID

Legal business name

IDAHO DENTAL ANESTHESIA PLLC

Practice address

37 W Archerfield St Ste 100
Meridian, ID 83646-6587

Phone

(208) 391-2894

NPI assigned

Sep 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ryan W Judd, DMDNPI 1609946078

Title

Dentist Anesthesiologist

Phone

(503) 679-9797

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ryan W Judd, DMD

  • Dental Anesthesiology
  • Eagle, ID
  • NPI 1609946078
  NPD Authorized official

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1629470141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 W ARCHERFIELD ST STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466587",
            "telephone_number": "208-391-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W ARCHERFIELD ST STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466587",
            "telephone_number": "208-391-2894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 E Heritage Park St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836466439",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 S River St",
            "address_purpose": "LOCATION",
            "city": "Hailey",
            "state": "ID",
            "postal_code": "833338426",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 Falls Ave E Ste 1000C",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833013459",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1408 Pomerelle Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Burley",
            "state": "ID",
            "postal_code": "833182068",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12190 W Evely Pines Ln",
            "address_purpose": "LOCATION",
            "city": "Star",
            "state": "ID",
            "postal_code": "836696126",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "478 SW 12th St",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "OR",
            "postal_code": "979143202",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "136 E Mallard Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837063975",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1186 Eastland Dr N",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833018973",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1311 E Central Dr",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836427991",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1619 N Whitley Dr",
            "address_purpose": "LOCATION",
            "city": "Fruitland",
            "state": "ID",
            "postal_code": "836192162",
            "country_code": "US",
            "telephone_number": "503-679-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IDAHO DENTAL ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "503-679-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "ID",
            "license": "D-4613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Arthritis & Osteoporosis Center PC
• Idaho Bariatric and Metabolic Institute L.L.C.
• Idaho Commission on Aging
• Idaho Consumer Direct Personal Care, LLC
• Idaho Counseling and Neurofeedback
• Idaho Dental Professionals, P.C.
• Idaho Dental Professionals, P.C.
• Idaho Dental Professionals, P.C.
• Idaho Ear Audiololgy
• Idaho Ear Clinic, PLLC

• All providers in Meridian, ID
• Dental Anesthesiology in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.