Town Square Dental-Burley PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TOWN SQUARE DENTAL-BURLEY PLLC

Practice address

1010 E Main St
Burley, ID 83318-2045

Phone

(208) 678-5597

Fax

(866) 882-4187

NPI assigned

Jun 6, 2024

Organization subpart

No

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

Authorized official

Name

Yuri Arteaga

Title

Office Manager

Phone

(208) 678-5597

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1992547442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E MAIN ST",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182045",
            "telephone_number": "208-678-5597",
            "fax_number": "866-882-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E MAIN ST",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182045",
            "telephone_number": "208-678-5597",
            "fax_number": "866-882-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN SQUARE DENTAL-BURLEY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "ARTEAGA",
        "authorized_official_first_name": "YURI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-678-5597"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.