NPIMap

Organization Active NPI

Heartwood Family Dental, PC

  • General Practice Dentistry
  • Post Falls, ID
National Provider Identifier
1992040299
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-4401 Issued in ID
Legal business name
HEARTWOOD FAMILY DENTAL, PC
Practice address
102 W 11TH Ave
Suite C
Post Falls, ID 83854-9255
Phone
(208) 777-1542
Fax
(208) 773-1490
NPI assigned
Nov 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Dr. Logan F Hazard, DMD
Title
President
Phone
(208) 215-1426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D-4401 ID Primary

Addresses

Primary practice location

102 W 11TH Ave
Suite C
Post Falls, ID 83854-9255

Mailing address

102 W 11TH Ave
Suite C
Post Falls, ID 83854-9255
Phone (208) 777-1542

National Provider Directory

National Provider Directory

Locations

102 W 11th Ave
Ste C
Post Falls, ID 83854
Phone (208) 777-1542

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1992040299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W 11TH AVE",
            "address_2": "SUITE C",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549255",
            "telephone_number": "208-777-1542",
            "fax_number": "208-773-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W 11TH AVE",
            "address_2": "SUITE C",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549255",
            "telephone_number": "208-777-1542",
            "fax_number": "208-773-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTWOOD FAMILY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "HAZARD",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-215-1426",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.