NPIMap

Organization Active NPI

O-Bar Family Dental

  • Dental Clinic/Center
  • Mackay, ID
National Provider Identifier
1871766519
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D4109 Issued in ID
Legal business name
O-BAR FAMILY DENTAL
Practice address
304 So Main
Mackay, ID 83251
Phone
(208) 588-3316
Fax
(208) 588-3166
NPI assigned
Apr 2, 2008
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Dr. Jed C. Snow, D.M.D.
Title
Doctor/Owner
Phone
(208) 588-3316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D4109 ID Primary

Addresses

Primary practice location

304 So Main
Mackay, ID 83251

Mailing address

P.O. Box 86
Mackay, ID 83251
Phone (208) 588-3316

Other identifiers 1

IdentifierTypeStateIssuer
9203474OtherIDIDAHO SMILES

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1871766519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 86",
            "city": "MACKAY",
            "state": "ID",
            "postal_code": "83251",
            "telephone_number": "208-588-3316",
            "fax_number": "208-588-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SO MAIN",
            "city": "MACKAY",
            "state": "ID",
            "postal_code": "83251",
            "telephone_number": "208-588-3316",
            "fax_number": "208-588-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O-BAR FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "JED",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "208-588-3316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D4109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO SMILES",
            "identifier": "9203474",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mackay, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.