NPIMap

Organization Active NPI

Grillz

  • Dental Clinic/Center
  • Caldwell, ID
National Provider Identifier
1750044699
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GRILLZ
Practice address
4513 Enterprise Way
Caldwell, ID 83605
Phone
(208) 936-9244
NPI assigned
Oct 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Dr. Ryan Michael Leininger, DMDNPI 1659805075
Title
General Dentist
Phone
(208) 936-9244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4513 Enterprise Way
Caldwell, ID 83605

Mailing address

4513 Enterprise Way
Caldwell, ID 83605
Phone (208) 936-9244

Other names 1

  • Ridgecrest Family Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1750044699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 ENTERPRISE WAY",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-936-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 ENTERPRISE WAY",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-936-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRILLZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "LEININGER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "208-936-9244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgecrest Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.