Eagle Rock Dental Care of Rexburg

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EAGLE ROCK DENTAL CARE OF REXBURG

Practice address

556 Trejo St Ste C
Rexburg, ID 83440-2626

Phone

(208) 359-2224

Fax

(208) 359-2250

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Trudee L Chapple

Title

Administrator

Phone

(208) 359-2224

Specialties & licenses 1

Addresses

Locations

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

• Ronald John Hammond, D.D.S.

  • General Practice Dentistry
  • Rexburg, ID
  • NPI 1205009933

  General Practice

  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1831213149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 TREJO ST STE C",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402626",
            "telephone_number": "208-359-2224",
            "fax_number": "208-359-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 TREJO ST STE C",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402626",
            "telephone_number": "208-359-2224",
            "fax_number": "208-359-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE ROCK DENTAL CARE OF REXBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "CHAPPLE",
        "authorized_official_first_name": "TRUDEE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-359-2224"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marlowe Dummar
• Matthew Dunham
• Kelly L Dustin, DO
• Dwayne M. Hansen MD PLLC
• Paul M Dye, MPT, MOTR/L, ATC,
• Eagle Vision Center PC
• East Idaho Mental Health LLC
• Brad Richard Egbert, D.C.
• Amie R Einerson, LPC
• Luke Einerson, PHD, LMFT, RH

• All providers in Rexburg, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.