Randall Orthodontics, P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D-3405-OR Issued in ID

Legal business name

RANDALL ORTHODONTICS, P.A.

Practice address

3285 E. 17TH St.
Ammon, ID 83406-6758

Phone

(208) 716-3690

NPI assigned

Jun 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Charles Jared Randall, D.D.S., M.S.

Title

Owner

Phone

(208) 716-3690

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243814400000",
    "number": "1902032246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 E. 17TH ST.",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 E. 17TH ST.",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066758",
            "telephone_number": "208-716-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL ORTHODONTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-716-3690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-3405-OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie Jo Radford, LMSW
• Rally to Rise Physical Therapy PLLC
• Martha Ramirez, B.A.
• Leticia Marlen Ramos
• Vanessa Ramsdell, LCSW
• Charles Jared Randall, DDS
• Lindsay Ann Rankin, PT, DPT
• Joseph Rasmussen
• Justin Rees, CPSS
• John Reese

• Orthodontics and Dentofacial Orthopedics Dentistry in Ammon, ID
• Providers in Ammon, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.