Eagle Dental Partnership PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EAGLE DENTAL PARTNERSHIP PLLC

Doing business as

Ascend Dental

Practice address

577 E State St
Eagle, ID 83616-5938

Phone

(208) 939-3500

Fax

(208) 939-3837

NPI assigned

Apr 18, 2019

Last updated

Aug 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Leah M. Gardoski

Title

Insurance Administrator

Phone

(208) 939-3500

Specialties & licenses 1

Addresses

Other names 1

• Ascend Dental Doing business as

Locations

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1639732399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 E STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165938",
            "telephone_number": "208-939-3500",
            "fax_number": "208-939-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 E STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165938",
            "telephone_number": "208-939-3500",
            "fax_number": "208-939-3837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 W State St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836167055",
            "country_code": "US",
            "telephone_number": "208-342-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAGLE DENTAL PARTNERSHIP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "GARDOSKI",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "208-939-3500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascend Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meghan Louise Dunnam, LPN
• Jacob Gary Dyer
• Aaron Dykstra, NP
• Eagle Chiropractic PC
• Eagle Cramer Chiropractic, P.a.
• Eagle Dermatology, PLLC
• Eagle Family Medicine P a
• Eagle Healthcare LLC
• Eagle Healthcare LLC
• Eagle Healthcare LLC

• General Practice Dentistry in Eagle, ID
• Providers in Eagle, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.