MBD PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MBD PLLC

Doing business as

Mt Baldy Dental Center

Practice address

1305 Hwy 2 West
Bluiding a Suite a
Sandpoint, ID 83864

Phone

(208) 263-6806

Fax

(208) 265-2231

NPI assigned

Dec 9, 2013

Last updated

Dec 9, 2013By 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

Ms. Lynn Jensen

Title

Finacial Officer

Phone

(208) 263-6806

Specialties & licenses 1

Addresses

Other names 1

• Mt Baldy Dental Center Doing business as

Locations

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1720419369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 HWY 2 WEST",
            "address_2": "BLUIDING A SUITE A",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "208-263-6806",
            "fax_number": "208-265-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 HWY 2 WEST",
            "address_2": "BLUIDING A SUITE A",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "208-263-6806",
            "fax_number": "208-265-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "FINACIAL OFFICER",
        "authorized_official_telephone_number": "208-263-6806",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt Baldy Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bethany Mason
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• Stephen M Mathis, PSY.D., A.A.P.T.A.
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• Sharon J McCahon, LCSW
• Erika McCall
• Lynette N McCanna, NP-C
• Erin E. McClure, P.T.
• Michael Andrew McIsaac, P.A.-C

• General Practice Dentistry in Sandpoint, ID
• Providers in Sandpoint, 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 Dec 9, 2013; 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.