Timothy C. Paventy DMD, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4286 Issued in ID

Legal business name

TIMOTHY C. PAVENTY DMD, LLC

Practice address

144 E Mallard Dr
Boise, ID 83706-3975

Phone

(208) 342-0873

NPI assigned

Mar 13, 2014

Organization subpart

No

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

Authorized official

Name

Timothy C Paventy, DMD

Title

Owner/Dentist

Phone

(208) 342-0315

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1649696741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 E MALLARD DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 E MALLARD DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063975",
            "telephone_number": "208-342-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY C. PAVENTY DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "PAVENTY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "208-342-0315",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timberline Sports Massage LLC
• Times Square Dental
• Times Square Dental
• Nicole Timme, RD
• Kevin Timmel, MD
• Timothy Floyd, MD, PLLC
• Timothy J Johans, MD
• Sean Timpane, MD
• Kyrstin Chelyn Tindall, LPC
• Jessica Noel Tiner

• General Practice Dentistry in Boise, ID
• Providers in Boise, 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 Mar 13, 2014; 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.