Boise Center for Cosmetic Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3229 Issued in ID

Legal business name

BOISE CENTER FOR COSMETIC DENTISTRY

Practice address

5360 N Eagle Road Suite 101
Boise, ID 83713

Phone

(208) 939-7620

Fax

(208) 939-7640

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Cynthia A McKim, DMD

Title

Practice Owner

Phone

(208) 939-7620

Specialties & licenses 1

Addresses

Other names 1

• Cynthia A Mckim DMD Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia Ann Bridges, D.M.D.

  • General Practice Dentistry
  • Boise, ID
  • NPI 1780778837
  NPD (past)
• Veronica Montgomery, D.D.S.

  • General Practice Dentistry
  • Boise, ID
  • NPI 1871877704
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922161272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 N EAGLE ROAD SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-939-7620",
            "fax_number": "208-939-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 N EAGLE ROAD SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-939-7620",
            "fax_number": "208-939-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE CENTER FOR COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKIM",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "208-939-7620",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "3229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cynthia A Mckim DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Boise Behavioral Medicine PLLC (Boise Behavioral Health PLLC)
• Boise Bench Dentistry
• Boise Brain and Body LLC
• Boise Brain Health
• Boise Caring Dentistry, P.C.
• Boise Children's Dentistry PLLC (Dr. Alexis Phillips Kids Dentist)
• Boise Chiropractic Inc
• Boise Counseling and Wellness
• Boise Counseling Center, LLC
• Boise Dental Center

• 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 Aug 22, 2020; 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.