NPIMap

Individual provider Active NPI

Ronald Eugene Mendenhall, D.D.S.

  • General Practice Dentistry
  • Post Falls, ID
National Provider Identifier
1790887297
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3772 Issued in ID
Practice address
101 W Mullan Ave
Post Falls, ID 83854-9217
Phone
(208) 773-4185
Fax
(208) 777-0341
NPI assigned
Sep 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-3772 ID Primary

Addresses

Primary practice location

101 W Mullan Ave
Post Falls, ID 83854-9217

Mailing address

101 W Mullan Ave
Post Falls, ID 83854-9217
Phone (208) 773-4185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D-3772IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dental Care Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1790887297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MULLAN AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549217",
            "telephone_number": "208-773-4185",
            "fax_number": "208-777-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MULLAN AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549217",
            "telephone_number": "208-773-4185",
            "fax_number": "208-777-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "RONALD",
        "middle_name": "EUGENE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.