NPIMap

Organization Active NPI

Emerald West Family Dentistry

  • Dentist
  • Boise, ID
National Provider Identifier
1639238124
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EMERALD WEST FAMILY DENTISTRY
Practice address
8850 W Emerald St
#150
Boise, ID 83704-4808
Phone
(208) 323-2294
Fax
(208) 323-2299
NPI assigned
Dec 8, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Jayne Blazek
Title
Office Manager
Phone
(208) 323-2294

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X ID Primary

Addresses

Primary practice location

8850 W Emerald St
#150
Boise, ID 83704-4808

Mailing address

8850 W Emerald St
#150
Boise, ID 83704-4808
Phone (208) 323-2294

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1639238124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8850 W EMERALD ST",
            "address_2": "#150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044808",
            "telephone_number": "208-323-2294",
            "fax_number": "208-323-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8850 W EMERALD ST",
            "address_2": "#150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044808",
            "telephone_number": "208-323-2294",
            "fax_number": "208-323-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD WEST FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BLAZEK",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-323-2294",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": null,
            "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 Jul 21, 2022; 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.