NPIMap

Organization Active NPI

Lynn R. Blaisdell, DDS, PA

  • General Practice Dentistry
  • Boise, ID
National Provider Identifier
1881853208
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D1697 Issued in ID
Legal business name
LYNN R. BLAISDELL, DDS, PA
Practice address
8877 W Hackamore Dr
Boise, ID 83709-1671
Phone
(208) 377-9696
Fax
(208) 377-9698
NPI assigned
Jun 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Dr. Lynn R Blaisdell, DDSNPI 1649208901
Title
President/Owner
Phone
(208) 377-9696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D1697 ID Primary

Addresses

Primary practice location

8877 W Hackamore Dr
Boise, ID 83709-1671

Mailing address

8877 W Hackamore Dr
Boise, ID 83709-1671
Phone (208) 377-9696

National Provider Directory

National Provider Directory

Locations

8877 W Hackamore Dr
Boise, ID 83709
Phone (208) 377-9696

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1881853208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8877 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091671",
            "telephone_number": "208-377-9696",
            "fax_number": "208-377-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8877 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091671",
            "telephone_number": "208-377-9696",
            "fax_number": "208-377-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN R. BLAISDELL, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "BLAISDELL",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "208-377-9696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

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