KELLY E. CARLEN, DDS PLLC (NPI# 1689849598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689849598 |
| Entity Type | Organization |
| Organization Name | KELLY E. CARLEN, DDS PLLC |
| Practice Address |
2811 12th Ave Rd Nampa ID 83686-8482 |
| Practice Telephone | 2084611060 |
| Practice Fax Number | 2084656303 |
| Mailing Telephone | 2084611060 |
| Mailing Fax Number | 2084656303 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |
| Authorized Official Name | DR. KELLY EDWARD CARLEN (OWNER) |
| Authorized Official Telephone | 2084611060 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D3271 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8061407 | 05 |
| Street Address |
2811 12TH AVE RD |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-8482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508816000 | Roarke Jake Miller | Dentist | 2811 12th Ave Rd, Nampa, ID 83686 | 2006-05-12 |
| 1437660388 | Sleep Right Idaho Pllc | Dentist | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2017-10-18 |
| 1063894145 | Todd Squires | Dentist | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2015-06-24 |
| 1962714139 | Shawn D Lee | Dentist | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2010-07-05 |
| 1457593584 | Todd L Squires Ddc Pllc | Clinic/Center | 2811 12th Ave Rd, Nampa, ID 83686 | 2009-04-06 |
| 1891954343 | Southridge Dental | Dentist | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2008-06-09 |
| 1053503573 | Kelly E Carlen | Dentist | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2007-08-17 |
| 1003010877 | Southridge Dental | Dentist | 2811 12th Ave Rd, Nampa, ID 83686-8482 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720698608 | Club 32 Dental | Clinic/Center | 624 3rd St S, Nampa, ID 83651-3840 | 2020-08-05 |
| 1053705178 | Onsite Dental, Pllc | Clinic/Center | 524 E Fujii Dr, Nampa, ID 83686-6906 | 2015-03-26 |
| 1407152721 | Idaho Center Dental Care | Clinic/Center | 5826 E Franklin Rd, Nampa, ID 83687-5020 | 2011-02-03 |
| 1881602639 | Community Health Clinics Inc | Clinic/Center | 11136 Moss Lane, Nampa, ID 83687 | 2006-08-04 |
| 1891396776 | Happy Healthy Smiles LLC | Clinic/Center | 1436 S Edgewater Cir, Nampa, ID 83686-5051 | 2020-11-05 |
| 1568944502 | Ns South | Clinic/Center | 1705 12th Ave Rd, Nampa, ID 83686-6104 | 2018-09-06 |
| 1265979629 | Community Health Clinics, Inc. | Clinic/Center | 207 1st St S, Nampa, ID 83651-3703 | 2017-01-24 |
| 1457593584 | Todd L Squires Ddc Pllc | Clinic/Center | 2811 12th Ave Rd, Nampa, ID 83686 | 2009-04-06 |
| 1093977647 | Russell C. Pool, Dmd, Pa | Clinic/Center | 109 12th Ave Rd, Nampa, ID 83686-5047 | 2008-06-25 |
| 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 |
| 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 |
| 1841643533 | Dental Partners Ustick Pllc | Clinic/Center | 4403 E Ustick Rd # 104, Caldwell, ID 83605-6802 | 2016-07-18 |
| 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.