TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA (NPI# 1750947925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750947925 |
| Entity Type | Organization |
| Organization Name | TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA |
| Practice Address |
939 Bryden Ave Lewiston ID 83501-5057 |
| Practice Telephone | 2087462668 |
| Practice Fax Number | 2087467413 |
| Mailing Telephone | 2087462668 |
| Mailing Fax Number | 2087467413 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |
| Authorized Official Name | CLAUDETTE KIM MEYER (OFFICE MANGER) |
| Authorized Official Telephone | 2086345255 |
| Is Organization Subpart | Y |
| Parent Organization Name | TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306362587 | Two Rivers Family & Cosmetic Dentistry, Pa | Dentist | 120 N A St, Grangeville, ID 83530-1211 | 2017-08-18 |
| 1871932392 | Two Rivers Family & Cosmetic Dentistry, Pa | Dentist | 616 S 10th Ave, Caldwell, ID 83605-4112 | 2013-06-18 |
| Street Address |
939 BRYDEN AVE |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-5057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013910371 | James E Pierce | Dentist | 939 Bryden Ave, #2, Lewiston, ID 83501-5057 | 2005-05-31 |
| 1558752204 | Bryden Family Vision | Optometrist | 939 Bryden Ave, Lewiston, ID 83501-5057 | 2015-02-16 |
| 1588071633 | Jason Scott Ritter | Optometrist | 939 Bryden Ave, Lewiston, ID 83501-5057 | 2014-07-21 |
| 1649601006 | Carmine Petracca | Clinic/Center | 939 Bryden Ave, Lewiston, ID 83501-5057 | 2013-12-10 |
| 1932119161 | Randy L. Sorensen Dmd Pa | Dentist | 939 Bryden Ave, Lewiston, ID 83501-5057 | 2006-08-09 |
| 1124037924 | Randy Lee Sorensen | Dentist | 939 Bryden Ave, Lewiston, ID 83501-5057 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972544724 | Central Maine Dental Health Center, LLC | Clinic/Center | 488 Sabattus St, Lewiston, ME 04240-4113 | 2006-06-10 |
| 1407254550 | Gentle Family Dentistry | Clinic/Center | 1065 Lisbon St, Lewiston, ME 04240-5749 | 2014-12-05 |
| 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 | ||||
Please comment or provide details below to improve the information on TWO RIVERS FAMILY & COSMETIC DENTISTRY, PA.
| 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.