Individual provider Active NPI

Duston Francis Connaughton, DDS

  • Dentist
  • Boise, ID
National Provider Identifier
1902909997
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D3709 Issued in ID
Practice address
7235 Emerald St
Suite B
Boise, ID 83704-8600
Phone
(208) 376-7740
Fax
(208) 376-0468
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D3709 ID Primary

Addresses

Primary practice location

7235 Emerald St
Suite B
Boise, ID 83704-8600

Mailing address

7235 Emerald St
Suite B
Boise, ID 83704-8600
Phone (208) 376-7740

Other identifiers 1

IdentifierTypeStateIssuer
6I450OtherIDBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831002293 ID Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2365758760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D3709IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Bench Dentistry Dentist PastSince Jun 6, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902909997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 EMERALD ST",
            "address_2": "SUITE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048600",
            "telephone_number": "208-376-7740",
            "fax_number": "208-376-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 EMERALD ST",
            "address_2": "SUITE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048600",
            "telephone_number": "208-376-7740",
            "fax_number": "208-376-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNAUGHTON",
        "first_name": "DUSTON",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6I450",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.