Individual provider Active NPI

Matthew R Buhrley, D.D.S., M.S.D.

  • Endodontics
  • Meridian, ID
National Provider Identifier
1912113036
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D-3991-EN Issued in ID
Practice address
742 W Cherry LN
Meridian, ID 83642-1617
Phone
(208) 888-1010
Fax
(208) 888-4488
NPI assigned
May 15, 2007
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D-3991-EN ID Primary

Addresses

Primary practice location

742 W Cherry LN
Meridian, ID 83642-1617

Mailing address

742 W Cherry LN
Meridian, ID 83642-1617
Phone (208) 888-1010

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
I20160519001918 ID Order and Referring Only - DentistPractitioner - Dentist 3173812880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-3991-ENIDMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Buhrley Endodontics and Microsurgery, PC PastSince Mar 31, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1912113036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421617",
            "telephone_number": "208-888-1010",
            "fax_number": "208-888-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421617",
            "telephone_number": "208-888-1010",
            "fax_number": "208-888-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUHRLEY",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "ID",
            "license": "D-3991-EN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.