NPIMap

Organization Active NPI

Stone Ridge Sugar City Dba Stone Ridge Dental

  • Dental Clinic/Center
  • Sugar City, ID
National Provider Identifier
1881045698
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D-4169 Issued in ID
Legal business name
STONE RIDGE SUGAR CITY DBA STONE RIDGE DENTAL
Practice address
3 E Center St
Sugar City, ID 83448-1247
Phone
(208) 656-2000
NPI assigned
Jun 23, 2016
Last updated
Jun 23, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
STONE RIDGE DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Dr. Curtis Carpenter, D.D.S.
Title
Owner/President
Phone
(208) 656-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D-4169 ID Primary

Addresses

Primary practice location

3 E Center St
Sugar City, ID 83448-1247

Mailing address

3 E Center St
Sugar City, ID 83448-1247
Phone (208) 656-2000

National Provider Directory

National Provider Directory
Tax ID family
Stone Ridge Dental Inc3 organizations share this tax ID, including this one
Part of
Stone Ridge Dental Inc

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1881045698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E CENTER ST",
            "city": "SUGAR CITY",
            "state": "ID",
            "postal_code": "834481247",
            "telephone_number": "208-656-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E CENTER ST",
            "city": "SUGAR CITY",
            "state": "ID",
            "postal_code": "834481247",
            "telephone_number": "208-656-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE RIDGE SUGAR CITY DBA STONE RIDGE DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONE RIDGE DENTAL",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "208-656-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-4169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar City, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.