DR. RYAN W JUDD (NPI# 1609946078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609946078 |
| Entity Type | Individual |
| Full Name | DR. RYAN W JUDD |
| Credential | DMD |
| Practice Address |
5360 N Eagle Rd Boise ID 83713-4901 |
| Mailing Address |
6373 N Heathrow Ct Boise ID 83713-0970 |
| Practice Telephone | 5036799797 |
| Mailing Telephone | 5036799797 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2015-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
D4613 | ID | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447629183 | Ryan Judd | Specialist/Technologist, Other | 27 Golden Dr, Easthampton, MA 01027-2565 | 2015-09-23 |
| Street Address |
5360 N EAGLE RD |
| City | BOISE |
| State | ID |
| Zip Code | 83713-4901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780778837 | Cynthia Ann Bridges | Dentist | 5360 N Eagle Rd, Suite 101, Boise, ID 83713-0963 | 2006-10-03 |
| 1629483987 | Blair Pediatric Dentistry PC | Dentist | 5360 N Eagle Rd, Suite 103, Boise, ID 83713-4901 | 2014-06-25 |
| 1871877704 | Veronica Montgomery | Dentist | 5360 N Eagle Rd, Suite # 101, Boise, ID 83713-4901 | 2011-10-11 |
| 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 | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629470141 | Idaho Dental Anesthesia Pllc | Dentist | 37 W Archerfield St Ste 100, Meridian, ID 83646-6587 | 2014-09-17 |
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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.