DR. KENNETH E RICHARDSON (NPI# 1053407585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053407585 |
| Entity Type | Individual |
| Full Name | DR. KENNETH E RICHARDSON |
| Credential | D.D.S. |
| Practice Address |
2720 Overland Road Boise ID 83705 |
| Practice Telephone | 2083455875 |
| Practice Fax Number | 2083458412 |
| Mailing Telephone | 2083455875 |
| Mailing Fax Number | 2083458412 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D1383 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | IDAHO STATE LICENSE | D1383 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861477127 | Kenneth Joe Richardson | Radiology | 1825 Park Place, Montgomery, AL 36117-3439 | 2005-12-09 |
| 1487822169 | Kenneth Carnell Richardson | Social Worker | 2150 Whitney Ave, Memphis, TN 38127-6662 | 2008-02-14 |
| 1992981047 | Kenneth Daniel Richardson | Dietetic Technician, Registered | 1141 N Monroe Dr, Xenia, OH 45385-1619 | 2008-01-18 |
| 1265571269 | Kenneth Erwin Richardson | Pediatrics | 1034 N 500 W, Neonatology, Provo, UT 84604-3380 | 2007-02-06 |
| 1992807515 | Kenneth R Richardson | Anesthesiology | 2201 Wadsworth Blvd, Lakewood, CO 80214-5708 | 2006-09-03 |
| 1922059815 | Kenneth W. Richardson | Nurse Anesthetist, Certified Registered | 4916 Overton Plz, Fort Worth, TX 76109-4415 | 2006-05-15 |
| Street Address |
2720 OVERLAND ROAD |
| City | BOISE |
| State | ID |
| Zip Code | 83705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760577332 | Martin T. Sachse, D.m.d., P.C. | Dentist | 2720 Overland Road, Boise, ID 83705 | 2006-10-03 |
| 1790870293 | Martin T Sachse | Dentist | 2720 Overland Road, Boise, ID 83705 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938779 | Halo Health Services LLC | Community/Behavioral Health | 1111 S Orchard St, Boise, Id 83705, Boise, ID 83705 | 2020-06-29 |
| 1598265860 | Felica Jo Duce | Counselor | 921 S Orchard St Ste 103, Boise, ID 83705 | 2018-02-13 |
| 1215364278 | Erica Zelickowski | Pharmacist | 1653 S Vista Avenue, Boise, ID 83705 | 2013-10-04 |
| 1952655490 | Aida Dizdar-barac | Social Worker | 2273 S. Vista Avenue, Suite 190, Boise, ID 83705 | 2012-11-06 |
| 1033461033 | Julie Marie Meek | Social Worker | 3324 W Elder St, Boise, ID 83705 | 2012-10-15 |
| 1568761112 | Berkeley Fraser | Pharmacist | 3527 S Federal Way Suite 104, Boise, ID 83705 | 2011-03-22 |
| 1922311042 | Amber Vania | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2010-07-18 |
| 1295056836 | Cherise M Wetzel | Social Worker | 1625 S Eagleson Rd, B1, Boise, ID 83705 | 2010-06-17 |
| 1558685305 | Rae Ann Norell | Social Worker | 2273 S. Vista Ave, #190 Treasure Valley Community Counseling Services, Boise, ID 83705 | 2010-03-23 |
| 1164679932 | Oreana Harless | Social Worker | 2550 South Vista Ave, Boise, ID 83705 | 2008-08-25 |
| Find all providers in zip 83705 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588273635 | Atlantis Dental Care, P.a. | Dentist | 13238 W Persimmon Ln Ste 100, Boise, ID 83713-1968 | 2020-07-24 |
| 1235747338 | Dentists of Boise and Orthodontics, PC | Dentist | 7500 W State St Ste 110, Boise, ID 83714-6074 | 2020-07-15 |
| 1346895232 | Tejasi Avasare | Dentist | 8321 W Overland Rd, Boise, ID 83709-1640 | 2019-08-07 |
| 1528610359 | Melissa Marie Pysnak | Dentist | 8850 W Emerald St Ste 150, Boise, ID 83704-4809 | 2019-07-11 |
| 1124684584 | Trevor Tafoya Dds Victory Dental, Pllc | Dentist | 7421 W Victory Rd, Boise, ID 83709-5106 | 2019-05-11 |
| 1982260360 | Brant Burbank | Dentist | 4255 N Eagle Rd Ste 102, Boise, ID 83713-0701 | 2019-05-11 |
| 1972023398 | Northview Dental Partnership LLC | Dentist | 7480 W Northview St, Boise, ID 83704-7232 | 2017-06-27 |
| 1962939421 | Travis Jon Weimer | Dentist | 8336 W Northview St, Boise, ID 83704-7132 | 2017-05-16 |
| 1922480284 | Jonathan W Pluid | Dentist | 4274 N Eagle Rd, Boise, ID 83713-0726 | 2015-06-23 |
| 1922489673 | Gray Team LLC | Dentist | 813 N Stilson Rd, Ste:b, Boise, ID 83703-5119 | 2015-06-17 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.