Organization Active NPI

Harrison Dental PLLC

  • Dental Clinic/Center
  • Boise, ID
National Provider Identifier
1942992326
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HARRISON DENTAL PLLC
Practice address
1675 W Hill Rd
Boise, ID 83702-0982
Phone
(208) 874-0697
NPI assigned
May 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Sean Wasden
Title
Coo
Phone
(208) 965-9415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1675 W Hill Rd
Boise, ID 83702-0982

Mailing address

624 3Rd St S
Nampa, ID 83651-3840

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1942992326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 3RD ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W HILL RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837020982",
            "telephone_number": "208-874-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "WASDEN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "208-965-9415"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.