Barry Wayne Jardine, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-3807 Issued in ID

Practice address

1910 S. Meridan Rd.
Suite 150
Meridian, ID 83642-4842

Phone

(208) 888-3540

Fax

(208) 888-3930

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Southern Springs Dental PLLC

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1730348236
  NPD (past) Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1992838627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S MERIDIAN RD",
            "address_2": "STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429061",
            "telephone_number": "208-888-3540",
            "fax_number": "208-888-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S. MERIDAN RD.",
            "address_2": "SUITE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424842",
            "telephone_number": "208-888-3540",
            "fax_number": "208-888-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "BARRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8069432",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyleen Victoria James
• Jacilynn Jangula Cox
• Whitney Janicki
• Janina Dowdy, LCSW, PLLC
• Michael Benjamin Jara, PMHNP
• Suzanne Jardine, APRN-CNP
• Jared M Furgeson DDS PLLC
• Shannon Christina Jares, NP
• Janice W Jarrard, FNP-C
• Jarrell Plastic Surgery

• General Practice Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.