Trista E Pottenger, DMD PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TRISTA E POTTENGER, DMD PLLC

Practice address

12212 W Amity Rd
Boise, ID 83709-5389

Phone

(208) 343-4732

Fax

(208) 343-3818

NPI assigned

Nov 3, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Trista E Pottenger, DMDNPI 1942641246

Title

Owner

Phone

(208) 484-8212

Specialties & licenses 1

Addresses

Other names 1

• High Desert Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Trista E Pottenger, DMD

  • General Practice Dentistry
  • Boise, ID
  • NPI 1942641246
  NPD Authorized official
• Matthew G. Fethke, D.D.S.

  • General Practice Dentistry
  • Boise, ID
  • NPI 1447343488
  NPD (past)

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1649935818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12212 W AMITY RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095389",
            "telephone_number": "208-343-4732",
            "fax_number": "208-343-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12212 W AMITY RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095389",
            "telephone_number": "208-343-4732",
            "fax_number": "208-343-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTA E POTTENGER, DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "POTTENGER",
        "authorized_official_first_name": "TRISTA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-484-8212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Desert Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinity Transport
• Dana J Triplitt
• Madeline Tripp
• Travis S Tripp, CRNA
• Caitlin Trisler, PHARMD
• Trivium Life Services Mountain West, LLC
• Francois D Trotta, MD, PA
• Ann Decker Trotter, PHD
• Betty R Trounson, RDLD
• Trenton Troxell, PHARMD

• Dental Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.