CORDELL DENTON NEBEKER (NPI# 1609106012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609106012 |
Entity Type | Individual |
Full Name | CORDELL DENTON NEBEKER |
Credential | D.D.S., M.S. |
Practice Address |
4111 Clocktower Ave. Caldwell ID 83607 |
Practice Telephone | 2084536188 |
Mailing Telephone | 2084536188 |
Enumeration Date | 2010-01-07 |
Last Update Date | 2015-03-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
8147013-9923 | UT | Dental Providers |
Street Address |
4111 CLOCKTOWER AVE. |
City | CALDWELL |
State | ID |
Zip Code | 83607 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265677587 | Cory Shane Lindstrom | Chiropractor | 5216 E. Cleveland Blvd, Ste G, Caldwell, ID 83607 | 2008-12-16 |
1154533727 | Reality Based Services | Case Management | 24151 El Paso Rd, Caldwell, ID 83607 | 2007-05-04 |
1407998271 | Patrick L Waite | Dentist | 4101 Clock Tower Ave, Caldwell, ID 83607 | 2007-02-12 |
1104276377 | Jae's Transportaion LLC | Non-emergency Medical Transport (VAN) | 14310 Tara St, Caldwell, ID 83607-1431 | 2016-06-17 |
1417224460 | Rebecca Anne Tormey | Physical Therapist | 1202 Talon Ct, Caldwell, ID 83607-1579 | 2011-11-18 |
1174677603 | Vallivue School District #139 | Local Education Agency (LEA) | 5207 S Montana Ave, Caldwell, ID 83607-1583 | 2007-01-22 |
1679026447 | Kimberly Drewrey, Aprn, Np-c | Point of Service | 5210 Cleveland Blvd, Suite 140 #344, Caldwell, ID 83607-1796 | 2016-07-28 |
1619007903 | Mandy R Redmond | Specialist/Technologist | 1407 E Homedale Rd, Caldwell, ID 83607-1848 | 2007-03-06 |
1326263179 | Kira Ann Skroh | Specialist/Technologist | 1407 E Homedale Rd, Caldwell, ID 83607-1848 | 2007-04-16 |
1891318622 | Casey Jay Milburn | Behavior Technician | 1109 Flint Dr, Caldwell, ID 83607-1859 | 2020-05-27 |
Find all providers in zip 83607 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801214135 | Paige Schmidt | Dentist | 4111 Clock Tower Ave, Caldwell, ID 83607-5006 | 2014-04-03 |
1144661844 | Smiles 4 Kids Caldwell | Dentist | 4111 Clock Tower Ave, Caldwell, ID 83607-5006 | 2013-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124657010 | Rigby Pediatric Dental Pllc | Dentist | 688 Rigby Lake Circle, Suite 4, Rigby, ID 83442 | 2020-04-03 |
1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
1902325749 | Cherry Lane Kids Dentistry | Dentist | 1558 N Crestmont Dr Ste A, Meridian, ID 83642-2194 | 2017-09-13 |
1922462142 | Our Town Family Dentistry | Dentist | 39 W Idaho St, Weiser, ID 83672-1943 | 2016-04-13 |
1720447097 | Brock Coletti | Dentist | 3235 N Towerbridge Way Ste 200, Meridian, ID 83646-5721 | 2016-02-15 |
1154799047 | Smiles 4 Kids Blackfoot Pllc | Dentist | 621 Jensen Grove Dr, Blackfoot, ID 83221-1685 | 2015-09-09 |
1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
1679812002 | Dentistry for Kids Pllc | Dentist | 625 E Alameda Rd., Pocatello, ID 83201 | 2013-02-05 |
1316192370 | A Childs Smile | Dentist | 3299 E. 17th Street, Ammon, ID 83406 | 2008-11-18 |
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.