EAGLE ROCK DENTAL CARE (NPI# 1356465660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356465660 |
| Entity Type | Organization |
| Organization Name | EAGLE ROCK DENTAL CARE |
| Practice Address |
640 S Woodruff Ave Idaho Falls ID 83401-5299 |
| Practice Telephone | 2085235400 |
| Practice Fax Number | 2085280565 |
| Mailing Telephone | 2085235400 |
| Mailing Fax Number | 2085280565 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2014-02-03 |
| Authorized Official Name | TRUDEE L CHAPPLE (ADMINISTRATOR) |
| Authorized Official Telephone | 2085235400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D-3271 | ID | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D-3063 | ID | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D-1890 | ID | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D4138 | ID | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D-1297 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | ISDA | D4138 | 01 |
| Street Address |
640 S WOODRUFF AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-5299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265075568 | Alison Burau | Social Worker | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2019-10-20 |
| 1497146823 | Salt Lake City Vamc | Clinic/Center | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2015-02-06 |
| 1295021632 | Blaine A Hammond | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2011-06-23 |
| 1811157001 | Nicholas J Tanner | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2008-06-11 |
| 1558534917 | Alan Ray Cooper | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2008-04-08 |
| 1265604995 | Steven Abbott Barnard | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2008-04-02 |
| 1760654487 | Douglas Steven Barnard | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2008-04-02 |
| 1821260555 | Cade Grimmett Baldwin | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2008-04-02 |
| 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 | 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 |
|---|---|---|---|---|
| 1396236501 | John Andrew Chappell | Dentist | 1820 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2018-05-23 |
| 1326395385 | Eagle Rock Dental Care Pllc | Dentist | 2205 Channing Way Ste B, Idaho Falls, ID 83404-8016 | 2012-08-09 |
| 1194046037 | Esther B. Machen | Dentist | 3500 Potomac Way, Suite 200, Idaho Falls, ID 83404-4974 | 2010-06-15 |
| 1003144114 | Sunnyside Dental Care PC | Dentist | 1520 Elk Creek Dr, Idaho Falls, ID 83404-8322 | 2009-12-01 |
| 1033443478 | Soft Touch Dental | Dentist | 3350 S 15 Th E, Idaho Falls, ID 83404 | 2009-10-01 |
| 1134356140 | Riverwest Dental, Pllc | Dentist | 1655 Pancheri Dr., Idaho Falls, ID 83402 | 2009-06-17 |
| 1932368222 | Elison Dental Center | Dentist | 3656 Washington Pkwy, Idaho Falls, ID 83404-7573 | 2008-06-03 |
| 1851590152 | Mark Aaron Chambers | Dentist | 2860 Valencia Dr Ste 101, Idaho Falls, ID 83404-7597 | 2007-07-16 |
| 1306053350 | Layne K Mccord | Dentist | 3411 Merlin Dr, Idaho Falls, ID 83404-7430 | 2007-05-17 |
| 1891837050 | Nathan Jay Crandall | Dentist | 1991 W Broadway St # 1, Idaho Falls, ID 83402-3041 | 2007-02-13 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on EAGLE ROCK DENTAL CARE.
| 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.