McKee Idaho Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MCKEE IDAHO DENTAL

Practice address

1541 E Clark St
Pocatello, ID 83201-4100

Phone

(208) 232-6400

Fax

(208) 232-6050

NPI assigned

Dec 4, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Paul Clark, DMD, MD

Title

Owner

Phone

(208) 232-6400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1972319085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 E CLARK STREET",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014100",
            "telephone_number": "208-232-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 E CLARK ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014100",
            "telephone_number": "208-232-6400",
            "fax_number": "208-232-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKEE IDAHO DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-232-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael T McHugh, DDS
• Alison Marie McInturff, M.D.
• Don E McInturff, M.D.
• Kasidy Laree McKay, PHARMD
• Lance W McKay, P.A.-C
• Seren Jenny McKee, TSLP
• Elizabeth Victoria McKenna
• Matthew L McKinlay, PA-C
• Theresa Lynn McKinney, D.D.S.
• Maja Page McKnight, M.T.

• Dentist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.