NPIMap

Organization Active NPI

R. Paul Kelson DDS Ms Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boise, ID
National Provider Identifier
1891931028
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
01561 Issued in ID
Legal business name
R. PAUL KELSON DDS MS ORTHODONTICS PA
Practice address
10497 Garverdale Court
#103
Boise, ID 83704
Phone
(208) 378-1300
Fax
(208) 375-3397
NPI assigned
Dec 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Authorized official

Name
Mrs. Diane C. Kelson
Title
Secretary
Phone
(208) 375-3397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 01561 ID Primary

Addresses

Primary practice location

10497 Garverdale Court
#103
Boise, ID 83704

Mailing address

10497 Garverdale Court
#103
Boise, ID 83704
Phone (208) 378-1300

National Provider Directory

National Provider Directory
Tax ID family
R Paul Kelson DDS Ms Orthodontics PA2 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1891931028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10497 GARVERDALE COURT",
            "address_2": "#103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-378-1300",
            "fax_number": "208-375-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10497 GARVERDALE COURT",
            "address_2": "#103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-378-1300",
            "fax_number": "208-375-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. PAUL KELSON DDS MS ORTHODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "KELSON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-375-3397",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "01561",
            "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 Dec 17, 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.