MOUNTAIN HOME DENTAL PC (NPI# 1801437447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801437447 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN HOME DENTAL PC |
| Practice Address |
455 N 3rd E Mountain Home ID 83647 |
| Mailing Address |
685 N 4th E Mountain Home ID 83647-2134 |
| Practice Telephone | 2085872625 |
| Mailing Telephone | 2085993189 |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | DR. JARED SEXAUER (DENTIST) |
| Authorized Official Telephone | 2085993189 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
455 N 3RD E |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952830945 | Jared Sexauer | Dentist | 455 N 3rd E, Mountain Home, ID 83647-2738 | 2017-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| Find all providers in zip 83647 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912529504 | Dover Dental D.d.s., P.a. Dba Dover Family Dentistry | Clinic/Center | 400 S College St Ste 4, Mountain Home, AR 72653-3991 | 2020-05-18 |
| 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 | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
Please comment or provide details below to improve the information on MOUNTAIN HOME DENTAL PC.
| 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.