Childrens Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D10349 Issued in OR

Legal business name

CHILDRENS DENTISTRY

Practice address

515 W Idaho Ave
Ontario, OR 97914-2348

Phone

(541) 709-5500

Fax

(208) 467-5199

NPI assigned

Mar 1, 2017

Organization subpart

Yes

Parent organization

CHILDRENS DENTISTRY OF IDAHOAs reported in NPPES

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

Authorized official

Name

Dr. Jeffrey C Bryson, DDS

Title

Owner

Phone

(208) 467-5100

Specialties & licenses 1

Addresses

Tax ID family

Children'S Dentistry of Idaho PLLC2 organizations share this tax ID, including this one

Part of

Children'S Dentistry of Idaho PLLC

Other organizations with this tax ID 1

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

• Children'S Dentistry of Idaho, PLLC

  • Pediatric Dentistry
  • Nampa, ID
  • NPI 1689942849
  NPD tax ID

Practitioners 1

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

• Scott Pickett, D.D.S.

  • General Practice Dentistry
  • Ammon, ID
  • NPI 1003222506

  Pediatric Dentistry

  NPD

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1790225399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W IDAHO AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142348",
            "telephone_number": "541-709-5500",
            "fax_number": "208-467-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W IDAHO AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142348",
            "telephone_number": "541-709-5500",
            "fax_number": "208-467-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDRENS DENTISTRY OF IDAHO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "BRYSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-467-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D10349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Lee Chase
• Landen Chau
• Alicia Chavez Trapero
• Brandy Lee Chavez
• Emmalee Naseakuh Cherry
• Brian Vernon Christensen, DO
• Brittany Coombs Chronister, FNP-C
• Daniel Chudleigh
• Cecile Ailene Chung
• Epiphanie Muhayimana Church

• All providers in Ontario, OR
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.