Philip Openshaw, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4989 Issued in ID

Practice address

201 S Paradise Ave
Middleton, ID 83644-5809

Phone

(208) 585-0048

Fax

(208) 466-5359

NPI assigned

Apr 4, 2007

Last updated

Mar 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1750403341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S PARADISE AVE",
            "city": "MIDDLETON",
            "state": "ID",
            "postal_code": "836445809",
            "telephone_number": "208-585-0048",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Orangeburg Ave",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953505342",
            "country_code": "US",
            "telephone_number": "209-524-4763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPENSHAW",
        "first_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34032",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Alexander Nelson, M.S, LPC
• TK Nelson
• Brenton James Noel, PA-C
• Ginny D. Noyes, M. ED.
• Steven B Ollie, M.D.
• Kami Pahlas, LCSW
• Alexa Perrigo, BCBA
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• Tiffany Pollock, OTR/L

• General Practice Dentistry in Middleton, ID
• Providers in Middleton, 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 Mar 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.