Couch-Burtenshaw Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1303 Issued in ID

Legal business name

COUCH-BURTENSHAW DENTAL

Practice address

1014 Erikson Dr
Rexburg, ID 83440-5297

Phone

(208) 359-5454

Fax

(208) 359-0749

NPI assigned

Apr 6, 2009

Last updated

Apr 6, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Reana Lyn

Title

Office Manager

Phone

(208) 359-5454

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1770725772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 ERIKSON DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405297",
            "telephone_number": "208-359-5454",
            "fax_number": "208-359-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ERIKSON DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405297",
            "telephone_number": "208-359-5454",
            "fax_number": "208-359-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUCH-BURTENSHAW DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "LYN",
        "authorized_official_first_name": "REANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-359-5454",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley S Cordero, DPT
• Grant Guy Cordner, DMD
• Core Connection
• Cornerstone Caregiving West LLC
• Cornerstone Family Dental PLLC
• Counseling & Treatment Center of Idaho
• Counseling & Treatment Center of Idaho, LLC
• County of Madison (Madison County Ambulance)
• County of Madison School District 321
• Covey and Smith LLC

• General Practice Dentistry in Rexburg, ID
• Providers in Rexburg, 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 Apr 6, 2009; 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.