Castlebury Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3724 Issued in ID

Legal business name

CASTLEBURY DENTAL PC

Practice address

3209 W. Bavaria St.
Eagle, ID 83616

Phone

(208) 855-0080

Fax

(208) 855-2582

NPI assigned

Mar 13, 2009

Last updated

Mar 13, 2009By 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

Jennifer Webster

Title

Office Manager

Phone

(208) 855-0080

Specialties & licenses 1

Addresses

Locations

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.

• Andrea Dawn Haney, DDS

  • Dentist
  • Boise, ID
  • NPI 1649651464
  NPD (past)
• Ashley P Sara, DMD

  • General Practice Dentistry
  • Eagle, ID
  • NPI 1265871354
  NPD (past)

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236902400000",
    "number": "1881835353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 W. BAVARIA ST.",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "83616",
            "telephone_number": "208-855-0080",
            "fax_number": "208-855-2582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 W. BAVARIA ST.",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "83616",
            "telephone_number": "208-855-0080",
            "fax_number": "208-855-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLEBURY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-855-0080"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Carr
• Mason Carter, NP-C
• Janet Houston Casabonne, M.S.,CCC-SLP
• Cascadia Hospice of Idaho LLC (Avencare Hospice)
• Isabella Castillo
• Cep America, LLC (Vituity)
• Colton Charles, DMD
• Rebecca Charlton
• Judith Lauren Chasin, MD
• Lauren Chavis, PSYD

• General Practice Dentistry in Eagle, ID
• Providers in Eagle, 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 Mar 13, 2009; 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.