Boise Children'S Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BOISE CHILDREN'S DENTISTRY PLLC

Practice address

136 E Mallard Dr
Boise, ID 83706-3975

Phone

(208) 500-5437

Fax

(208) 908-6178

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Alexis Phillips Lyall, DMD

Title

Owner Dentist

Phone

(208) 500-5437

Specialties & licenses 2

Addresses

Other names 1

• Dr. Alexis Phillips Kids Dentist Doing business as

Locations

Practitioners 1

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

• Alexis Phillips, D.M.D.

  • Pediatric Dentistry
  • Boise, ID
  • NPI 1346771904
  NPD

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1700503133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E MALLARD DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063975",
            "telephone_number": "208-500-5437",
            "fax_number": "208-908-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E MALLARD DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063975",
            "telephone_number": "208-500-5437",
            "fax_number": "208-908-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE CHILDREN'S DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "LYALL",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "PHILLIPS",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "208-500-5437",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Alexis Phillips Kids Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Boise Bench Dentistry
• Boise Brain and Body LLC
• Boise Brain Health
• Boise Caring Dentistry, P.C.
• Boise Center for Cosmetic Dentistry
• Boise Chiropractic Inc
• Boise Counseling and Wellness
• Boise Counseling Center, LLC
• Boise Dental Center
• Boise Dermaesthetics, LLC

• Pediatric Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.