NPIMap

Organization Active NPI

Brookside Dental

  • General Practice Dentistry
  • Nampa, ID
National Provider Identifier
1851312839
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3312 Issued in ID
Legal business name
BROOKSIDE DENTAL
Practice address
351 W Iowa Ave
Nampa, ID 83686-2856
Phone
(208) 461-2600
Fax
(208) 461-3166
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robbie Roland Hamblin, D.M.D.NPI 1720002769
Title
Manager
Phone
(208) 461-2600

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3312 ID Primary

Addresses

Primary practice location

351 W Iowa Ave
Nampa, ID 83686-2856

Mailing address

351 W Iowa Ave
Nampa, ID 83686-2856
Phone (208) 461-2600

National Provider Directory

National Provider Directory

Locations

351 W Iowa Ave
Nampa, ID 83686
Phone (208) 282-6000

Practitioners & affiliated clinicians

Practitioners 2

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851312839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-461-2600",
            "fax_number": "208-461-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-461-2600",
            "fax_number": "208-461-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAMBLIN",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_middle_name": "ROLAND",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-461-2600",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "3312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • 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.