DR. JERRY MICHAEL CARBONE (NPI# 1316050628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316050628 |
| Entity Type | Individual |
| Full Name | DR. JERRY MICHAEL CARBONE |
| Credential | D.M.D. |
| Practice Address |
12249 W Mcmillan Rd Boise ID 83713-0555 |
| Practice Telephone | 2089172855 |
| Practice Fax Number | 2082587553 |
| Mailing Telephone | 2089172855 |
| Mailing Fax Number | 2082587553 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2014-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D-3642EN | ID | Dental Providers |
| Street Address |
12249 W MCMILLAN RD |
| City | BOISE |
| State | ID |
| Zip Code | 83713-0555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730197690 | Scott Alan Wright | Dentist | 12249 W Mcmillan Rd, Boise, ID 83713-2471 | 2006-08-04 |
| 1134522535 | Intermountain Dental Specialists | Clinic/Center | 12249 W Mcmillan Rd, Boise, ID 83713-0555 | 2014-09-30 |
| 1821180944 | Kenyon L Oyler | Dentist | 12249 W Mcmillan Rd, Contenntal Dental Center, Boise, ID 83713-0555 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437455961 | Herbert Ray Blaser | Dentist | 2104 N. Cole Rd., Boise, ID 83704 | 2011-02-01 |
| 1396961157 | Larue Antoine Bluth | Dentist | 5244 N Eagle Rd, Boise, ID 83713-0945 | 2007-04-18 |
| 1417096678 | Idaho Endodontics Pa | Dentist | 2014 N Cole Rd, Boise, ID 83704 | 2007-02-05 |
| 1932259173 | Brent L Chapman | Dentist | 1555 S Timesquare Ln, Boise, ID 83709-8266 | 2007-01-11 |
| 1811077589 | Hilary I Dunstan | Dentist | 6363 W Emerald St Ste 102, Boise, ID 83704-8783 | 2006-10-17 |
| 1124139134 | Michael John Bingham | Dentist | 3308 N Milwaukee St, Boise, ID 83704-4447 | 2006-08-31 |
| 1710509823 | Idaho Endodontics | Dentist | 1555 S Timesquare Ln, Boise, ID 83709-8266 | 2020-05-12 |
| 1407483027 | Northwest Dental Group | Dentist | 8300 Northview St, Boise, ID 83704 | 2020-03-24 |
| 1881861581 | Robert Olson Jr. | Dentist | 8119 Ustick Rd, Boise, ID 83704-5754 | 2008-05-12 |
| 1114077369 | Adam J Shipp | Dentist | 1555 S Timesquare Ln, Boise, ID 83709-8266 | 2007-01-11 |
| 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.