Active NPI
John Howell Mumford, D.M.D.
- Periodontics
- Boise, ID
National Provider Identifier
1639149057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D-2027
- Practice address
- 140 E Boise Ave
Boise, ID 83706 - Phone
- (208) 385-9228
- Fax
- (208) 385-9292
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D-2027 | ID | Primary |
Addresses
Primary practice location
140 E Boise Ave
Boise, ID 83706
Mailing address
16801 E. Mission Parkway
Apt P204
Spokane Valley, WA 99216
Phone (301) 332-9219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-2027 | ID | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Periodontal Health Specialists of Idaho | Periodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Periodontics
- Boise, ID
- NPI 1689077026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446681600000",
"number": "1639149057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16801 E. MISSION PARKWAY",
"address_2": "APT P204",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "99216",
"telephone_number": "301-332-9219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 E BOISE AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "83706",
"telephone_number": "208-385-9228",
"fax_number": "208-385-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUMFORD",
"first_name": "JOHN",
"middle_name": "HOWELL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2015-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "ID",
"license": "D-2027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.