WELLPOINT DENTAL (NPI# 1194980417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194980417 |
| Entity Type | Organization |
| Organization Name | WELLPOINT DENTAL |
| Practice Address |
2700 W Cherry Ln Meridian ID 83642-1137 |
| Practice Telephone | 2088879000 |
| Mailing Telephone | 2088879000 |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2008-07-25 |
| Authorized Official Name | DR. WARREN R WILLIS (CO-OWNER) |
| Authorized Official Telephone | 2088879000 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DH-1189 | ID | Dental Providers |
| Street Address |
2700 W CHERRY LN |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-1137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013924208 | Jared Furgeson | Dentist | 2700 W Cherry Ln, Suite 120, Meridian, ID 83642-1137 | 2006-08-01 |
| 1598115644 | Ten Mile Smiles Inc | Dentist | 2700 W Cherry Ln, Ste 120, Meridian, ID 83642-1500 | 2016-06-20 |
| 1013924117 | Jared M Furgeson Dds Pllc | Clinic/Center | 2700 W Cherry Ln, Suite 120, Meridian, ID 83642-1137 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| 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 |
|---|---|---|---|---|
| 1891304556 | Birchwood Dental, Pllc | Dentist | 3325 N Ten Mile Rd Ste 140, Meridian, ID 83646-6951 | 2020-07-29 |
| 1659619609 | Eagle Smiles Dentistry and Orthodontics, PC | Dentist | 6700 N Linder Rd Ste 132, Meridian, ID 83646-6608 | 2013-01-26 |
| 1699037333 | Jon Thomas Flint | Dentist | 3512 Highway 39 N, Meridian, MS 39301-1305 | 2012-06-08 |
| 1659632529 | Quinn Allen Brown | Dentist | 2635 N Devlin Ave, Meridian, ID 83646-1566 | 2012-06-06 |
| 1083975304 | Rhett Yeakley Dmd, Pllc | Dentist | 1570 E Heritage Park St Ste 100, Meridian, ID 83646-5886 | 2012-06-04 |
| 1811254931 | Meridian Community College | Dentist | 910 Highway 19 North, Meridian, MS 39307 | 2012-04-13 |
| 1619124039 | Rahil Akhtar | Dentist | 1505 S. Eagle Rd, Meridian, ID 83642 | 2008-08-27 |
| 1164684312 | Aesthetic Smiles | Dentist | 4795 N Summit Way Ste 120, Meridian, ID 83646-5017 | 2008-06-30 |
| 1881854123 | Jonathan N Scott | Dentist | 110 E. Ustick Rd., Meridian, ID 83646 | 2008-06-10 |
| 1730348236 | Southern Springs Dental Pllc | Dentist | 1910 S Meridian Rd, Ste 150, Meridian, ID 83642-9061 | 2008-06-09 |
| Find all providers in MERIDIAN | ||||
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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.