ANDREW STODDARD DENTAL SERVICES, PLLC (NPI# 1346501657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346501657 |
| Entity Type | Organization |
| Organization Name | ANDREW STODDARD DENTAL SERVICES, PLLC |
| Practice Address |
1525 Baldy Ave Pocatello ID 83201-7117 |
| Practice Telephone | 2082380011 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |
| Authorized Official Name | ANDREW STODDARD (SOLE MEMBER) |
| Authorized Official Telephone | 2082380011 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D-4149 | ID | Ambulatory Health Care Facilities |
| Street Address |
1525 BALDY AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-7117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376852939 | Center for Dental Excellence LLC | Clinic/Center | 1525 Baldy Ave, Pocatello, ID 83201-7117 | 2010-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376852939 | Center for Dental Excellence LLC | Clinic/Center | 1525 Baldy Ave, Pocatello, ID 83201-7117 | 2010-09-30 |
| 1841345261 | Bringhurst Family Dentistry, Pllc | Clinic/Center | 1175 Call Pl Ste 200, Pocatello, ID 83201-3078 | 2007-01-24 |
| 1770127565 | Portneuf Valley Dental | Clinic/Center | 1246 Yellowstone Ave, Pocatello, ID 83201-4374 | 2019-11-05 |
| 1083143739 | Desert Valley Dentistry | Clinic/Center | 716 Yellowstone Ave, Pocatello, ID 83201-4407 | 2017-06-07 |
| 1164686069 | Dr Darryl D Bybee Dds | Clinic/Center | 1169 Call Creek Pl, Suite A, Pocatello, ID 83201 | 2008-07-10 |
| 1851566392 | G. William Godfrey, Dds Lee R. Reddish, Dds Pllc | Clinic/Center | 1980 Birdie Thompson Dr, Pocatello, ID 83201-2755 | 2008-04-25 |
| 1891918603 | Michael T Mchugh D.d.s., Pa | Clinic/Center | 1246 Yellowstone Ave, Ste. D3, Pocatello, ID 83201-4374 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864384 | Kuna Kids Dentistry PC | Clinic/Center | 1385 N Jacksonmill Ave, Kuna, ID 83634-2042 | 2020-09-08 |
| 1720691785 | Advanced Dentistry of Mccall | Clinic/Center | 313 Deinhard Ln, Mccall, ID 83638-4703 | 2020-08-28 |
| 1720698608 | Club 32 Dental | Clinic/Center | 624 3rd St S, Nampa, ID 83651-3840 | 2020-08-05 |
| 1831732502 | Hughes Dental Pllc | Clinic/Center | 834 Falls Ave Ste 2030, Twin Falls, ID 83301-3365 | 2019-10-24 |
| 1083279087 | Idaho Buckeye Inc | Clinic/Center | 1537 2nd Ave S, Payette, ID 83661-2919 | 2019-05-06 |
| 1639637168 | Scott Carter, Inc | Clinic/Center | 982 Banks Lowman Rd, Garden Valley, ID 83622 | 2019-03-04 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1831678903 | Town Square Dental Partners, Pllc | Clinic/Center | 8660 W Emerald St Ste 152, Boise, ID 83704-4828 | 2018-08-09 |
| 1265935902 | Wilson Dental Pllc | Clinic/Center | 10497 W Garverdale Ct Ste 107, Boise, ID 83704-5468 | 2018-03-08 |
| Find all providers with the same taxonomy | ||||
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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.