Brent Charles Goldthorpe, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4080 Issued in ID

Practice address

120 Desert Sage Way
Mountain Home, ID 83647-1038

Phone

(208) 696-7203

Fax

(208) 587-3324

NPI assigned

Jul 28, 2008

Last updated

Mar 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit View Dental Services PLLC

  • Dentist
  • Mackay, ID
  • NPI 1265878995
  NPD (past) Authorized official
• Glenns Ferry Health Center, Inc.

  dba Desert Sage Health Centers

  • Federally Qualified Health Center (FQHC)
  • Grand View, ID
  • NPI 1972633949
  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1992960116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 DESERT SAGE WAY",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836471038",
            "telephone_number": "208-587-3988",
            "fax_number": "208-587-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DESERT SAGE WAY",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836471038",
            "telephone_number": "208-696-7203",
            "fax_number": "208-587-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDTHORPE",
        "first_name": "BRENT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2358",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenns Ferry Health Center, Inc. (Desert Sage Health Centers)
• Glenns Ferry Health Center, Inc. (Desert Sage Pharmacy)
• Glenns Ferry Health Center, Inc. (Desert Sage Health Centers)
• Glenns Ferry Health Center, Inc. (Desert Sage Health Center)
• Amy Jo Glover
• John Earl Goodrich, DDS
• Lisa Jo Goodsell, RN,MSN,PCCN
• Terri Lynn Grasham
• Katherine Gray, M.D.
• Paige Gray

• General Practice Dentistry in Mountain Home, ID
• Providers in Mountain Home, 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 Mar 18, 2024; 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.