Meridian Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D-3592-PD Issued in ID

Legal business name

MERIDIAN PEDIATRIC DENTISTRY, PLLC

Practice address

1550 E Heritage Park St Ste 150
Meridian, ID 83646-5886

Phone

(208) 288-2719

Fax

(208) 288-2579

NPI assigned

Jun 5, 2008

Last updated

Jun 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Toby MerrimanNPI 1407801939

Title

Owner

Phone

(208) 288-2719

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Toby O Merriman, DMD

  • Pediatric Dentistry
  • Meridian, ID
  • NPI 1407801939
  NPD (past) Authorized official

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1811156722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 E HERITAGE PARK ST STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465886",
            "telephone_number": "208-288-2719",
            "fax_number": "208-288-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E HERITAGE PARK ST STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465886",
            "telephone_number": "208-288-2719",
            "fax_number": "208-288-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "MERRIMAN",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-288-2719"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D-3592-PD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806274800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meridian Healthcare LLC (Creekside Transitional Care and Rehabilitation)
• Meridian Hearing AIDS LLC (Leslie Milliken)
• Meridian Lighthouse Counseling
• Meridian Marriage and Family Therapy, LLC
• Meridian Neuropsychology PLLC
• Meridian Pediatrics
• Meridian Physical Medicine
• Meridian Psychological Center PC
• Meridian Smiles Dentistry, PC (Meridian Smiles Dentistry and Orthodontics)
• Meridian Therapeutic Massage LLC (Meridian Therapeutic Massage)

• Pediatric Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• Pediatric Dentistry in Idaho

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