Silver Lake Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3104 Issued in ID

Legal business name

SILVER LAKE DENTAL PLLC

Practice address

6176 N Government Way
Dalton Gardens, ID 83815-7331

Phone

(208) 762-3027

Fax

(208) 762-0531

NPI assigned

Jun 10, 2008

Last updated

Jun 10, 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

Mr. James S Hough, DDS

Title

Owner

Phone

(208) 762-3027

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

James S Hough DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Silver Lake Dental PLLC

  dba James S Hough DDS

  • General Practice Dentistry
  • Cour D Alene, ID
  • NPI 1982709390
  NPD tax ID

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1851551345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6176 N GOVERNMENT WAY",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838157331",
            "telephone_number": "208-762-3027",
            "fax_number": "208-762-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6176 N GOVERNMENT WAY",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838157331",
            "telephone_number": "208-762-3027",
            "fax_number": "208-762-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER LAKE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "HOUGH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-762-3027",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL PRACTICE DENTIST",
            "identifier": "1223G0001X",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Dalton Gardens, ID
• Providers in Dalton Gardens, 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 Jun 10, 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.