Eagle Anesthesia & Oral Surgery PLLC

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

Legal business name

EAGLE ANESTHESIA & ORAL SURGERY PLLC

Practice address

5266 N Eagle Rd
Boise, ID 83713-0945

Phone

(503) 679-9797

NPI assigned

Aug 7, 2024

Last updated

Aug 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Judd, DMDNPI 1609946078

Title

Dentist Anesthesiologist

Phone

(503) 679-9797

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan W Judd, DMD

  • Dental Anesthesiology
  • Eagle, ID
  • NPI 1609946078
  NPD Authorized official

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1972333565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 W ARCHERFIELD ST STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467721",
            "telephone_number": "503-679-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5266 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "503-679-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE ANESTHESIA & ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DENTIST ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "503-679-9797",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodie Dzaich Pounders, LPC
• Jeffrey S Dzieczkowski, MD
• Joanna Dziewa, APRN-CNP
• Erin M Eadington, LPC, NCC
• Matalynn Belle Eager, LPC
• Eagle Health and Wellness, Inc
• Eagle Medical Supply LLC
• Eagle's View Family Medicine, PC
• Kimi Jo Eames, LCSW
• Bryan James Earl, DO

• Dental Anesthesiology in Boise, ID
• Providers in Boise, ID by specialty
• Dental Anesthesiology in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.