Mountain Home Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MOUNTAIN HOME DENTAL PC

Practice address

455 N 3Rd E
Mountain Home, ID 83647

Phone

(208) 587-2625

NPI assigned

Oct 4, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jared Sexauer, DMDNPI 1952830945

Title

Dentist

Phone

(208) 599-3189

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jared Sexauer, DMD

  • General Practice Dentistry
  • Mountain Home, ID
  • NPI 1952830945
  NPD Authorized official

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1801437447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 N 4TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472134",
            "telephone_number": "208-599-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 N 3RD E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "83647",
            "telephone_number": "208-587-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "SEXAUER",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-599-3189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P Koelsch MD
• Frank Monasterio, LPC
• Laura Jean Moulton, R.D.N.
• Mountain Gem Counseling, LLC
• Mountain Home Behavioral Health LLC
• Mountain Home Nutrition Services LLC
• Mountain Home Physical Therapy, PC
• Mountain Home School District 193
• Timothy James Muhonen, MD
• Vernon T Mullins, MSN, APRN, FNP-BC

• Dental Clinic/Center in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.