Brent R. Unruh, DMD, PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D-1764 Issued in ID

Legal business name

BRENT R. UNRUH, DMD, PA

Practice address

1717 Lincoln Way
Suite 107
Coeur D Alene, ID 83814-2556

Phone

(208) 664-0489

Fax

(208) 769-7339

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Brent UnruhNPI 1619195310

Title

President

Phone

(208) 664-0489

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.

• Brent Unruh

  • Periodontics
  • Coeur D Alene, ID
  • NPI 1619195310
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881746048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 LINCOLN WAY",
            "address_2": "SUITE 107",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142556",
            "telephone_number": "208-664-0489",
            "fax_number": "208-769-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 LINCOLN WAY",
            "address_2": "SUITE 107",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142556",
            "telephone_number": "208-664-0489",
            "fax_number": "208-769-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT R. UNRUH, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UNRUH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-664-0489"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "ID",
            "license": "D-1764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillienne Braucher Sells, DPT
• Bailey Braun, PA-C
• Kellie Kathryn Breaux, FNP-MSN
• Lisa G Breisacher, L.N.P.
• Jill Efta Breitbach, PSY D
• Brevity Treatment Services
• Bri Health PLLC
• Brian L Norce
• Brian L Samuels MD PLLC
• Brick House Recovery

• Periodontics in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Periodontics 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.