RUSSELL GUYMON ORTHODONTICS, PA (NPI# 1194097402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194097402 |
| Entity Type | Organization |
| Organization Name | RUSSELL GUYMON ORTHODONTICS, PA |
| Practice Address |
333 S Woodruff Ave Idaho Falls ID 83401-4322 |
| Practice Telephone | 2085293500 |
| Mailing Telephone | 2085293500 |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |
| Authorized Official Name | DR. RUSSELL J GUYMON (OWNER/ORTHODONTIST) |
| Authorized Official Telephone | 2085293500 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
D-4402-OR | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 10584378285 | 05 |
| Street Address |
333 S WOODRUFF AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-4322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609977891 | John Owen | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2006-09-26 |
| 1235565003 | Kevin Mudrow Dds Pllc | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2013-09-24 |
| 1295995652 | Vernon O. Gaffner, D.m.d., P.a. | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2008-06-10 |
| 1093981011 | Owen Dental, PC | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2008-04-30 |
| 1972779916 | Scott M. Blake, Dds, PC | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2008-04-30 |
| 1114126992 | Kevin Richard Mudrow | Dentist | 333 S Woodruff Ave, Suite F, Idaho Falls, ID 83401-4322 | 2007-07-12 |
| 1821130253 | Jeffrey W Johnson | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2007-02-13 |
| 1376684175 | Scott M Blake | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2007-02-12 |
| 1376627802 | Vernon O Gaffner | Dentist | 333 S Woodruff Ave, Idaho Falls, ID 83401-4322 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1194169649 | Jordan Rodney Hillam | Dentist | 758 E 65th S, Idaho Falls, ID 83404-7696 | 2013-04-25 |
| 1598053712 | Bret E. Mooso D.d.s.,m.s. | Dentist | 1580 Elk Creek Drive, Idaho Falls, ID 83404-6269 | 2011-07-21 |
| 1043441363 | Jared B Gill | Dentist | 3000 Pancheri Dr, Suite 1, Idaho Falls, ID 83402-5095 | 2009-08-04 |
| 1225289390 | Rodney H. Hillam | Dentist | 3325 S. Holmes Ave., Idaho Falls, ID 83404 | 2008-10-07 |
| 1306973862 | Rodney H Hillam Dds Ms Pa | Dentist | 3325 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2007-02-28 |
| 1902949969 | Phillip David Lowder | Dentist | 250 South Skyine Drive, Ste 4, Idaho Falls, ID 83402 | 2007-02-15 |
| 1053496083 | Dwight Douglas Baker | Dentist | 1900 John Adams Pkwy, Idaho Falls, ID 83401-4366 | 2006-10-26 |
| 1902902208 | Brett Eddis Mooso | Dentist | 1410 E 17th St, Idaho Falls, ID 83404-6269 | 2006-09-15 |
| 1740215870 | Elison Orthodontics Pllc | Dentist | 3357 Merlin Dr, Idaho Falls, ID 83404-7405 | 2006-07-11 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on RUSSELL GUYMON ORTHODONTICS, PA.
| 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.