Organization Active NPI

Poppleton Family Dentistry

  • General Practice Dentistry
  • Twin Falls, ID
National Provider Identifier
1972765865
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3554 Issued in ID
Legal business name
POPPLETON FAMILY DENTISTRY
Practice address
1001 Shoshone St N
Twin Falls, ID 83301-6364
Phone
(208) 733-0695
Fax
(208) 736-4540
NPI assigned
Jul 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Kyle David Poppleton, D.D.S.NPI 1841229002
Title
Owner
Phone
(208) 733-0695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D-3554 ID Primary

Addresses

Primary practice location

1001 Shoshone St N
Twin Falls, ID 83301-6364

Mailing address

1001 Shoshone St N
Twin Falls, ID 83301-6364

Other identifiers 1

IdentifierTypeStateIssuer
806115400MedicaidID

National Provider Directory

National Provider Directory

Locations

1001 Shoshone St N
Twin Falls, ID 83301
Phone (208) 733-0695

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1972765865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SHOSHONE ST N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SHOSHONE ST N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016364",
            "telephone_number": "208-733-0695",
            "fax_number": "208-736-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPPLETON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "POPPLETON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-733-0695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806115400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.