Denture Clinic of Pocatello, Inc.

Primary specialty

DenturistTaxonomy code 122400000X

License

LD-98 Issued in ID

Legal business name

DENTURE CLINIC OF POCATELLO, INC.

Practice address

115 S 15TH Ave Ste D
Pocatello, ID 83201-4052

Phone

(208) 232-2558

Fax

(208) 232-2558

NPI assigned

Dec 3, 2013

Organization subpart

Yes

Parent organization

DENTURE CLINIC OF POCATELLO, INC.As reported in NPPES

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

Authorized official

Name

Mr. Geno Alan Giovanini, L.DNPI 1205365632

Title

Owner

Phone

(208) 232-2558

Specialties & licenses 1

Addresses

Part of

Denture Clinic of Pocatello Inc

Locations

Practitioners 1

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

• Geno Alan Giovanini

  • Denturist
  • Pocatello, ID
  • NPI 1205365632
  NPD (past) Authorized official

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1720419674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 15TH AVE STE D",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014052",
            "telephone_number": "208-232-2558",
            "fax_number": "208-232-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S 15TH AVE STE D",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014052",
            "telephone_number": "208-232-2558",
            "fax_number": "208-232-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTURE CLINIC OF POCATELLO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTURE CLINIC OF POCATELLO, INC.",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "GIOVANINI",
        "authorized_official_first_name": "GENO",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-232-2558",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.D"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": "ID",
            "license": "LD-98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Demeter-Gietzen, LSW
• Kelsey Marie Denison, PMHNP-BC
• Dentistry for Kids PLLC
• David M Denton, M.D.
• Denture Arts, Inc.
• Aneree H Desai, M.D
• Edward Desano, MD
• Mikayla Louise Deschamps
• Deseret Care, LLC
• Desert Valley Dentistry

• Denturist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Denturist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.