NPIMap

Individual provider Active NPI

Kristine B Ali, DMD

  • General Practice Dentistry
  • Boise, ID
National Provider Identifier
1982860987
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-4960 Issued in ID
Practice address
2301 N 36TH St Ste 102
Boise, ID 83703-5202
Phone
(208) 336-8801
Fax
(208) 466-5359
NPI assigned
Jul 30, 2008
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-4960 ID Primary

Addresses

Primary practice location

2301 N 36TH St Ste 102
Boise, ID 83703-5202

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 461-7149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718000472 NM Order and Referring Only - DentistPractitioner - Dentist 9234421900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Wartell Enterprises, LLC General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients
Community Health Clinics, Inc. General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kali608098@direct.ochin.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1982860987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-461-7149",
            "fax_number": "208-467-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N 36TH ST STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837035202",
            "telephone_number": "208-336-8801",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "KRISTINE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.