NPIMap

Organization Active NPI

Jeffrey F. Sowle DDS PA

  • General Practice Dentistry
  • Kendrick, ID
National Provider Identifier
1790959609
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
66D1616 Issued in ID
Legal business name
JEFFREY F. SOWLE DDS PA
Practice address
601 East Main St
Kendrick, ID 83537-0160
Phone
(208) 289-3221
Fax
(208) 289-3721
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. Jeffrey F. Sowle, DDSNPI 1902828767
Title
President
Phone
(208) 289-3221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 66D1616 ID Primary

Addresses

Primary practice location

601 East Main St
Kendrick, ID 83537-0160

Mailing address

PO Box 160
Kendrick, ID 83537-0160
Phone (208) 289-3221

Other identifiers 2

IdentifierTypeStateIssuer
002462000MedicaidID
5037569MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1790959609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "KENDRICK",
            "state": "ID",
            "postal_code": "835370160",
            "telephone_number": "208-289-3221",
            "fax_number": "208-289-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EAST MAIN ST",
            "city": "KENDRICK",
            "state": "ID",
            "postal_code": "835370160",
            "telephone_number": "208-289-3221",
            "fax_number": "208-289-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY F. SOWLE DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "SOWLE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-289-3221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "66D1616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002462000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5037569",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendrick, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.