Individual provider Active NPI

Brooks Joseph Uniat, DDS

  • General Practice Dentistry
  • Caldwell, ID
National Provider Identifier
1639184120
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3666 Issued in ID
Practice address
1913 S Kimball Ave
Caldwell, ID 83605-4829
Phone
(208) 459-0113
Fax
(208) 459-7831
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D3666 ID Primary

Addresses

Primary practice location

1913 S Kimball Ave
Caldwell, ID 83605-4829

Mailing address

1913 S Kimball Ave
Caldwell, ID 83605-4829
Phone (208) 459-0113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160328001088 ID Order and Referring Only - DentistPractitioner - General PracticePractitioner - Dentist 6305143942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D3666IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Uniat Dentistry Inc CurrentSince Aug 8, 2021 Accepting new patients

Locations

1913 S Kimball Ave
Caldwell, ID 83605
Phone (208) 459-0113

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1639184120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 S KIMBALL AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054829",
            "telephone_number": "208-459-0113",
            "fax_number": "208-459-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 S KIMBALL AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054829",
            "telephone_number": "208-459-0113",
            "fax_number": "208-459-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNIAT",
        "first_name": "BROOKS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.