NPIMap

Organization Active NPI

Shaun Christensen, DMD, PC

Doing business as Middle Creek Dental

  • General Practice Dentistry
  • Nampa, ID
National Provider Identifier
1790899409
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3588 Issued in ID
Legal business name
SHAUN CHRISTENSEN, DMD, PC
Doing business as
Middle Creek Dental
Practice address
155 S Midland Blvd
Nampa, ID 83686-2601
Phone
(208) 466-7424
Fax
(208) 466-7512
NPI assigned
Aug 18, 2006
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Shaun Christensen, DMDNPI 1568560712
Title
Owner / Dentist
Phone
(208) 466-7424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D3588 ID Primary

Addresses

Primary practice location

155 S Midland Blvd
Nampa, ID 83686-2601

Mailing address

155 S Midland Blvd
Nampa, ID 83686-2601
Phone (208) 466-7424

Other names 1

  • Middle Creek Dental Doing business as

National Provider Directory

National Provider Directory

Locations

155 S Midland Blvd
Nampa, ID 83686
Phone (208) 466-7424

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1790899409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S MIDLAND BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862601",
            "telephone_number": "208-466-7424",
            "fax_number": "208-466-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 S MIDLAND BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862601",
            "telephone_number": "208-466-7424",
            "fax_number": "208-466-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAUN CHRISTENSEN, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "208-466-7424",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middle Creek Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.