NPIMap

Organization Active NPI

Two Rivers Dental, PLLC

  • General Practice Dentistry
  • Challis, ID
National Provider Identifier
1962644260
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3280 Issued in ID
Legal business name
TWO RIVERS DENTAL, PLLC
Practice address
810 Hwy 93 S
Challis, ID 83226
Phone
(208) 879-2124
Fax
(208) 879-2169
NPI assigned
Apr 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Dr. Shane Lee Newton, D.M/D., P.A.
Title
Owner
Phone
(208) 315-2842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D3280 ID Primary

Addresses

Primary practice location

810 Hwy 93 S
Challis, ID 83226

Mailing address

PO Box 298
Challis, ID 83226-0298
Phone (208) 879-2124

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Dental PLLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1962644260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "832260298",
            "telephone_number": "208-879-2124",
            "fax_number": "208-879-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 HWY 93 S",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "83226",
            "telephone_number": "208-879-2124",
            "fax_number": "208-879-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-315-2842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M/D., P.A."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Challis, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.