Braden C Comstock, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-5068 Issued in ID

Practice address

333 S Main St Ste 110
Ketchum, ID 83340-9410

Phone

(208) 272-0075

NPI assigned

Aug 2, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Braden C. Comstock, DMD, PLLC

  dba Trail Creek Family Dental

  • General Practice Dentistry
  • Ketchum, ID
  • NPI 1457050619
  NPD Authorized official

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1740835248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S MAIN ST STE 110",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833409410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S MAIN ST STE 110",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833409410",
            "telephone_number": "208-272-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMSTOCK",
        "first_name": "BRADEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-02",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sasha Sherylle Chavez, NP-C
• Sydney Chickrell, RN
• Blair Choate, BSN
• James Cleveland, CRNA
• Garrett Coman, M.D.
• Ashlyn Cooper, PHARMD
• Catherine Cox, LMFT
• Colleen Ann Coyne, PT
• Peter Curran, MD
• Martha M Curry

• General Practice Dentistry in Ketchum, ID
• Providers in Ketchum, 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 27, 2023; 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.