Idaho Dental Aid, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-3065 Issued in ID

Legal business name

IDAHO DENTAL AID, PLLC

Practice address

604 3Rd St S
Nampa, ID 83651-3840

Phone

(208) 466-9088

Fax

(208) 466-2294

NPI assigned

Jun 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kim Benson Keller, DDS

Title

Owner

Phone

(208) 466-9088

Specialties & licenses 1

Addresses

Tax ID family

Idaho Dental Aid PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Idaho Dental Aid PLLC

  • Dentist
  • Nampa, ID
  • NPI 1912342544
  NPD tax ID

Locations

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1891921052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 3RD ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513840",
            "telephone_number": "208-466-9088",
            "fax_number": "208-466-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 3RD ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513840",
            "telephone_number": "208-466-9088",
            "fax_number": "208-466-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO DENTAL AID, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "BENSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-466-9088",
        "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": "D-3065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Arts Charter School
• Idaho Center Dental Care
• Idaho Counseling Center LLP
• Idaho CVS Pharmacy LLC
• Idaho Dental Aid PLLC
• Idaho Department of Health & Welfare
• Idaho Department of Health and Welfare Esc Region III
• Idaho Dept of Health & Welfare Itp Region 3
• Idaho Em-I Medical Services PC
• Idaho Endoscopy Center LLC

• All providers in Nampa, ID
• General Practice Dentistry in Idaho

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