Dennis J Page PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

M-6970 Issued in ID

Legal business name

DENNIS J PAGE PLLC

Doing business as

BodyLogicMD of Boise

Practice address

445 S Fitness PL
Suite B
Eagle, ID 83616-6828

Phone

(877) 552-7884

Fax

(877) 552-7885

NPI assigned

Apr 26, 2010

Organization subpart

No

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

Authorized official

Name

Dennis Page, M.D.

Title

Director

Phone

(877) 552-7884

Specialties & licenses 1

Addresses

Other names 1

• BodyLogicMD of Boise Doing business as

Locations

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1750608105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 S FITNESS PL",
            "address_2": "SUITE B",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166828",
            "telephone_number": "877-552-7884",
            "fax_number": "877-552-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S FITNESS PL",
            "address_2": "SUITE B",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166828",
            "telephone_number": "877-552-7884",
            "fax_number": "877-552-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS J PAGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-552-7884",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "M-6970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BodyLogicMD of Boise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adele R Dela Roaa, LMT
• Samantha Jane Dembski, M.S.,CCC-SLP
• Marie Demers, MA, LPC
• Matthew Demers, LMT
• Denali Ridge Couseling
• Jonas Dethman
• Dewdrops Dietetics
• Valerie Dewolfe
• Emily R Diaz
• Victor Dimbi

• Specialist in Eagle, ID
• Providers in Eagle, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.