IDEAL DENTAL (NPI# 1073891461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073891461 |
| Entity Type | Organization |
| Organization Name | IDEAL DENTAL |
| Practice Address |
329 E Logan St Caldwell ID 83605-4863 |
| Practice Telephone | 2084593388 |
| Practice Fax Number | 2084539295 |
| Mailing Telephone | 2084593388 |
| Mailing Fax Number | 2084539295 |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2011-08-02 |
| Authorized Official Name | DR. TRAVIS BOYER (OWNER) |
| Authorized Official Telephone | 2084593388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D3896 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | NPI | 1194808238 | 01 |
| ID | NPI | 1992715304 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760866800 | Ideal Dental | Dentist | 216 W Little York Rd, Ste B, Houston, TX 77076-1432 | 2015-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | IDEAL DENTAL CARE INC | 8111 Midlothian Turnpike, North Chesterfield, VA 23235-5115 |
| Virginia Business Entities | IDEAL DENTAL CARE INC. | 8111 Midlothian Tpke, Richmond, Virginia 23235 |
| Colorado Business Entities | Ideal Dental Erie PLLC | 680 Mitchel Way, Unit 170, Erie, CO 80156 |
| Street Address |
329 E LOGAN ST |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-4863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457704009 | Kss Dental Group Pllc | Dentist | 329 E Logan St, Caldwell, ID 83605-4863 | 2016-07-19 |
| 1154773869 | Russell Powell | Dentist | 329 E Logan St, Caldwell, ID 83605-4863 | 2016-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| 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 |
|---|---|---|---|---|
| 1366805491 | Daniel Richard Huffmire | Dentist | 4403 E Ustick Rd Ste 104, Caldwell, ID 83605-6843 | 2016-04-05 |
| 1013184928 | Michael Elassar | Dentist | 501 Bloomfield Ave, Suite 2e, Caldwell, NJ 07006-5427 | 2008-05-09 |
| 1104099118 | Christensen Dental Pllc | Dentist | 4111 Clock Tower Ave, Caldwell, ID 83607-5006 | 2008-04-10 |
| 1669683595 | L.layne Drgac | Dentist | 602 N Gray St, Caldwell, TX 77836-1111 | 2007-05-24 |
| 1518094697 | Edward E. Baker, D.d.s., P.a. | Dentist | 45 Smull Ave, Caldwell, NJ 07006-5001 | 2007-02-27 |
| 1407998271 | Patrick L Waite | Dentist | 4101 Clock Tower Ave, Caldwell, ID 83607 | 2007-02-12 |
| 1881748184 | William F Burns | Dentist | West Essex Dental Group, 110 Bloomfield Ave, Caldwell, NJ 07006-5336 | 2007-01-23 |
| 1003900861 | Essex Dental P.C. | Dentist | 155 Roseland Ave., Ste. 6, Caldwell, NJ 07006-5903 | 2006-10-03 |
| 1346351491 | Gmn Tri-county Cac, Inc. | Dentist | 606 West St, Caldwell, OH 43724-1229 | 2006-08-31 |
| 1942311196 | Kirby Lynn Clendenon | Dentist | 1711 S 10th Ave, Caldwell, ID 83605 | 2006-08-31 |
| Find all providers in CALDWELL | ||||
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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.