Riverview Dental South PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RIVERVIEW DENTAL SOUTH PLLC

Practice address

1331 S Five Mile Rd
Boise, ID 83709

Phone

(208) 375-3754

Fax

(208) 375-3758

NPI assigned

Aug 1, 2024

Organization subpart

Yes

Parent organization

RIVERVIEW DENTAL PLLCAs reported in NPPES

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

Authorized official

Name

Mrs. Erin Colleen Shea

Title

Office Manager

Phone

(208) 375-3754

Specialties & licenses 1

Addresses

Tax ID family

Riverview Dental South PLLC2 organizations share this tax ID, including this one

Part of

Riverview Dental South PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Riverview Dental PLLC

  • Dental Clinic/Center
  • Boise, ID
  • NPI 1942919139
  NPD tax ID

Locations

Practitioners 2

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

• Quinn Allen Brown, DMD

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1659632529
  NPD
• Douglas Craig Hymas, D.D.S.

  • General Practice Dentistry
  • Boise, ID
  • NPI 1346455854
  NPD (past)

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1780413112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 S FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-375-3754",
            "fax_number": "208-375-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 S FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-375-3754",
            "fax_number": "208-375-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERVIEW DENTAL SOUTH PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERVIEW DENTAL PLLC",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-375-3754",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Rehab Inc
• Riverside Rehab, Inc
• Riverside Rehab, Inc.
• Riversong Speech and Language
• Riverview Dental PLLC
• Jeremy Gary Rivett, RN
• RJB Psychology, PLLC
• Rjlft, LLC
• RJN Boise, LLC
• Ira Roach, LCSW

• General Practice Dentistry in Boise, ID
• Providers in Boise, 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 Aug 1, 2024; 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.