NPIMap

Organization Active NPI

Two Rivers Family & Cosmetic Dentistry, PA

  • Dental Clinic/Center
  • Hailey, ID
National Provider Identifier
1639886898
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA
Practice address
116 W Bullion St
Hailey, ID 83333-8425
Phone
(208) 788-4507
NPI assigned
Oct 27, 2022
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Claudette Kim Meyer
Title
Office Manager
Phone
(208) 634-5255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

116 W Bullion St
Hailey, ID 83333-8425

Mailing address

307 E Park St Ste 103
McCall, ID 83638-3863
Phone (208) 634-5255

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Family Cosmetic Dentistry PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

116 W Bullion St
Hailey, ID 83333
Phone (208) 788-4507

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1639886898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E PARK ST STE 103",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836383863",
            "telephone_number": "208-634-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W BULLION ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338425",
            "telephone_number": "208-788-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-634-5255"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hailey, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.