NPIMap

Organization Active NPI

Christopher R Wells DMD PC

  • Dentist
  • Boise, ID
National Provider Identifier
1801811732
Registry record updated Dec 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-3568 Issued in ID
Legal business name
CHRISTOPHER R WELLS DMD PC
Practice address
1880 Judith LN Ste 210
Boise, ID 83705-3185
Phone
(208) 345-2771
Fax
(208) 345-2888
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2008

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

Authorized official

Name
Dr. Christopher R Wells, DMDNPI 1447421995
Title
Owner/President
Phone
(208) 345-2771

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D-3568 ID Primary

Addresses

Primary practice location

1880 Judith LN Ste 210
Boise, ID 83705-3185

Mailing address

1880 Judith LN Ste 210
Boise, ID 83705-3185
Phone (208) 345-2771

Other identifiers 4

IdentifierTypeStateIssuer
6J432OtherIDBLUE CROSS OF IDAHO
ID03568AOtherIDDELTA DENTAL
806186200MedicaidID
1347936OtherIDUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

1880 W Judith Ln
Ste 210
Boise, ID 83705
Phone (208) 345-2771

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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229731200000",
    "number": "1801811732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 JUDITH LN STE 210",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053185",
            "telephone_number": "208-345-2771",
            "fax_number": "208-345-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 JUDITH LN STE 210",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053185",
            "telephone_number": "208-345-2771",
            "fax_number": "208-345-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER R WELLS DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-12-20",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "208-345-2771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-3568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "6J432",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "ID03568A",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806186200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1347936",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

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