Portneuf Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PORTNEUF DENTAL PLLC

Doing business as

Superior Smiles

Practice address

115 S 15TH Ave
Suite #E
Pocatello, ID 83201-4004

Phone

(208) 233-4310

Fax

(208) 233-4368

NPI assigned

Dec 3, 2015

Last updated

Feb 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darcy Jo Hochstrasser

Title

Office Manager

Phone

(208) 233-4310

Specialties & licenses 1

Addresses

Other names 1

• Superior Smiles Doing business as

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1669847596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 15TH AVE",
            "address_2": "SUITE #E",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014004",
            "telephone_number": "208-233-4310",
            "fax_number": "208-233-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S 15TH AVE",
            "address_2": "SUITE #E",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014004",
            "telephone_number": "208-233-4310",
            "fax_number": "208-233-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTNEUF DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "HOCHSTRASSER",
        "authorized_official_first_name": "DARCY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-233-4310"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Pope, DPT
• Bonnie Porter, BA
• John C Porter, NP-C
• Portneuf ASC, LLC
• Portneuf Brace Company, LLC
• Portneuf Home Health Care, LLC (Portneuf Home Health Care)
• Portneuf Medical Center
• Portneuf Medical Center
• Portneuf Medical Center
• Portneuf Medical Center

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, 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 Feb 2, 2016; 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.