Phillip David Lowder, D.D.S., M.CL.D

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D3600-OR Issued in ID

Practice address

250 South Skyine Drive
Ste 4
Idaho Falls, ID 83402

Phone

(208) 524-1404

Fax

(208) 524-1114

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Valley Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rigby, ID
  • NPI 1548431588
  NPD (past) Authorized official
• Mongillo Orthodontics, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Idaho Falls, ID
  • NPI 1043904659
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1902949969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SHELL FLOWER RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748049",
            "telephone_number": "702-451-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SOUTH SKYINE DRIVE",
            "address_2": "STE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83402",
            "telephone_number": "208-524-1404",
            "fax_number": "208-524-1114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Stockham Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Rigby",
            "state": "ID",
            "postal_code": "834421275",
            "country_code": "US",
            "telephone_number": "208-745-7404",
            "fax_number": "208-745-7365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1069 Summers Dr",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834405335",
            "country_code": "US",
            "telephone_number": "208-356-8708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOWDER",
        "first_name": "PHILLIP",
        "middle_name": "DAVID",
        "credential": "D.D.S., M.CL.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S3100",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D3600-OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany L Love, LCPC
• Greg Loveland, LSW
• Amanda Loveless, BA
• Angelette Amanda Lovell, RDN
• Zachary Steven Lovell, DC
• Adam J Lowe, D.D.S.
• Aaron Lowry, OT
• Wendy Loyd, LPC
• Peter Ludwig, LMT.
• Mandy J Luis, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho Falls, ID
• Providers in Idaho Falls, 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 Mar 28, 2019; 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.