North End Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-1933 Issued in ID

Legal business name

NORTH END DENTAL PLLC

Practice address

704 N 17TH Street
Boise, ID 83702

Phone

(208) 344-0134

Fax

(208) 388-3990

NPI assigned

Aug 30, 2006

Last updated

Dec 11, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dorothy Ann Mattefs

Title

Off MGR

Phone

(208) 344-0134

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• North End Dental, PLLC Other name

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anna M Budolfson, DMD

  • General Practice Dentistry
  • Boise, ID
  • NPI 1841353018
  NPD (past)
• Andrew Beth Chrisman, DDS

  • General Practice Dentistry
  • Boise, ID
  • NPI 1043373210
  NPD (past)
• Alice Malloy Zeigler, D.M.D.

  • Dentist
  • Boise, ID
  • NPI 1942458005
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260489600000",
    "number": "1902916018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 N 17TH STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-344-0134",
            "fax_number": "208-388-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N 17TH STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-344-0134",
            "fax_number": "208-388-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH END DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-12-11",
        "status": "A",
        "authorized_official_last_name": "MATTEFS",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFF MGR",
        "authorized_official_telephone_number": "208-344-0134",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1933",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4007",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3957",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-1933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "69948",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807523400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000998900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North End Dental, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heather Norris, CD(DONA)
• Noah Norris
• Rose Norris
• Troy David Norris, D.C.
• North End Children's Health Clinic
• North End Psychiatry
• North Star Counseling, LLC
• Danielle North, DPT
• Thomas James North
• Northend Wellness, LLC

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.