Rogue River Sleep Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROGUE RIVER SLEEP DENTISTRY

Practice address

205 N Berkley St
Council, ID 83612-5015

Phone

(206) 818-0492

NPI assigned

Apr 16, 2019

Organization subpart

No

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

Authorized official

Name

Michael Aaron Holm, DDS

Title

Dentist/Owner

Phone

(206) 818-0492

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1669035655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 AIRPORT RD",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836725759",
            "telephone_number": "206-818-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BERKLEY ST",
            "city": "COUNCIL",
            "state": "ID",
            "postal_code": "836125015",
            "telephone_number": "206-818-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE RIVER SLEEP DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "206-818-0492",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Council, ID
• Providers in Council, 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 Apr 16, 2019; 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.