NPIMap

Organization Active NPI

Two Rivers Dental

  • Dental Clinic/Center
  • McCall, ID
National Provider Identifier
1669612776
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D3280 Issued in ID
Legal business name
TWO RIVERS DENTAL
Practice address
307 E Park St Ste 203
McCall, ID 83638-5255
Phone
(208) 634-5255
Fax
(208) 634-1047
NPI assigned
Mar 2, 2009
Last updated
Mar 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Authorized official

Name
Dr. Shane L Newton, DMDNPI 1619049962
Title
Owner
Phone
(208) 634-5255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D3280 ID Primary

Addresses

Primary practice location

307 E Park St Ste 203
McCall, ID 83638-5255

Mailing address

307 E Park St Ste 203
McCall, ID 83638-5255
Phone (208) 634-5255

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Dental PLLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

307 E Park St
Ste 203
McCall, ID 83638
Phone (208) 634-5255

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1669612776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E PARK ST STE 203",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385255",
            "telephone_number": "208-634-5255",
            "fax_number": "208-634-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E PARK ST STE 203",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385255",
            "telephone_number": "208-634-5255",
            "fax_number": "208-634-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-634-5255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D3280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McCall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.