Legacy Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-3902 Issued in ID

Legal business name

LEGACY DENTAL

Practice address

1685 Pancheri Dr
Idaho Falls, ID 83402-3169

Phone

(208) 523-0840

Fax

(208) 523-0921

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Oliver Oneal Thuernagle, DMDNPI 1215958376

Title

Dentist

Phone

(208) 523-0840

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Oliver Oneal Thuernagle, DMD

  • General Practice Dentistry
  • Idaho Falls, ID
  • NPI 1215958376
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841204609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 JUPITER HILLS DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016344",
            "telephone_number": "208-528-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 PANCHERI DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023169",
            "telephone_number": "208-523-0840",
            "fax_number": "208-523-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THUERNAGLE",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "ONEAL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-523-0840",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jae Lee
• Kevin P. Lee, L.M.S.W.
• Myrna Lee, P.A.-C
• Richard Lee
• Michael Edward Leemhuis, MSN, APRN, CNP, FNP
• Jayce Lehman
• Dallin Robert Leifson, PT, DPT
• Benjamin Leishman, D.O.
• Christina Lemek, BS
• Lemhi Valley Social Services, Inc.

• General Practice Dentistry in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• General Practice Dentistry in Idaho

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