Our Town Family Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

OUR TOWN FAMILY DENTISTRY

Practice address

39 W Idaho St
Weiser, ID 83672-1943

Phone

(208) 414-4444

NPI assigned

Apr 13, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Garth Stoddard, DMD

Title

Owning Doctor

Phone

(208) 453-6188

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1922462142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 CLOCK TOWER AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075006",
            "telephone_number": "208-453-6188",
            "fax_number": "208-459-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 W IDAHO ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836721943",
            "telephone_number": "208-414-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR TOWN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "STODDARD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "GARTH",
        "authorized_official_title_or_position": "OWNING DOCTOR",
        "authorized_official_telephone_number": "208-453-6188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Weiser, ID
• Providers in Weiser, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.