DR. BROOKE MARIE-OSGOOD FUKUOKA (NPI# 1932466489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932466489 |
| Entity Type | Individual |
| Full Name | DR. BROOKE MARIE-OSGOOD FUKUOKA |
| Other Name | DR. BROOKE MARIE-OSGOOD FUKUOKA |
| Practice Address |
1309 Bennett Ave Burley ID 83318-2676 |
| Mailing Address |
1508 N Lyndon St Jerome ID 83338-5026 |
| Practice Telephone | 2086787796 |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2016-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D-4533 | ID | Dental Providers |
| Street Address |
1309 BENNETT AVE |
| City | BURLEY |
| State | ID |
| Zip Code | 83318-2676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033165550 | Family Health Services Corporation | Counselor | 1309 Bennett Ave, Burley, ID 83318 | 2006-05-26 |
| 1043873789 | Angie Zabala | Social Worker | 1309 Bennett Ave, Burley, ID 83318-2676 | 2019-04-18 |
| 1477902161 | Taylor Mcallister | Physician Assistant | 1309 Bennett Ave, Burley, ID 83318-2676 | 2016-06-03 |
| 1346608999 | Lyndsie Chatburn | Nurse Practitioner | 1309 Bennett Ave, Burley, ID 83318-2676 | 2016-02-10 |
| 1316322167 | Logan Kay | Dentist | 1309 Bennett Ave, Burley, ID 83318-2676 | 2015-07-22 |
| 1619350774 | Family Health Services Corporation | Durable Medical Equipment & Medical Supplies | 1309 Bennett Ave, Burley, ID 83318-2676 | 2015-07-07 |
| 1164834040 | David Miller | Family Medicine | 1309 Bennett Ave, Burley, ID 83318 | 2014-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902366834 | Pain & Spine Consultants | Clinic/Center | 1344 Hiland Avenue, Ste A, Burley, ID 83318 | 2019-03-25 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1831654243 | Mini-cassia Hearts 4 Seniors | In Home Supportive Care | 135 East 23rd Drive, Burley, ID 83318 | 2019-02-11 |
| 1841760493 | Burley Family Dental Pllc | Dentist | 2200 Parke Ave Ste 2, Burley, ID 83318 | 2018-11-27 |
| 1831634823 | Skye Fahnlander | Occupational Therapy Assistant | 2303 Parke Ave, Burley, ID 83318 | 2016-12-29 |
| 1285024497 | Albion Valley Health Clinic Inc. | Clinic/Center | 400 West 5th Street, Burley, ID 83318 | 2015-01-26 |
| 1124372370 | A Plus Solutions Center | Clinic/Center | 2311 Parke Ave. Unit 3, Suite 12, Burley, ID 83318 | 2012-11-08 |
| 1831442805 | A Plus Solutions Developmental Center LLC | Day Training, Developmentally Disabled Services | 2251 Overland Avenue, Suite Number 5, Burley, ID 83318 | 2012-10-16 |
| 1619258159 | Keleah Margrete Goldammer | Occupational Therapist | 2303 Parke Avenue, Burley, ID 83318 | 2011-08-29 |
| 1932490984 | Tamera Chatburn | Counselor | 531 East 5th St., Preferred Child and Family Services, Burley, ID 83318 | 2011-04-26 |
| Find all providers in zip 83318 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841760493 | Burley Family Dental Pllc | Dentist | 2200 Parke Ave Ste 2, Burley, ID 83318 | 2018-11-27 |
| 1528223963 | Alan Scott Pickup | Dentist | 1905 Hiland Ave, Burley, ID 83318-2714 | 2008-07-24 |
| 1518128933 | Travis T Bodily | Dentist | 425 North Overland Avenue, Burley, ID 83318 | 2008-06-18 |
| 1821117763 | Val Garn | Dentist | 2200 Parke Ave, Suite 1, Burley, ID 83318-3351 | 2007-03-29 |
| 1710011754 | Jared C Johnson | Dentist | 1706 Overland Ave, Burley, ID 83318-2436 | 2007-03-14 |
| 1851495170 | Ronald C Rice | Dentist | 515 E 5th St. N, Burley, ID 83318 | 2006-09-08 |
| 1801819313 | Kevin Turner Stock | Dentist | 2200 Park Ave, Suite 2, Burley, ID 83318-2186 | 2006-07-25 |
| 1679066310 | Bodily Brothers Dental | Dentist | 425 N Overland Ave, Burley, ID 83318-3434 | 2018-06-07 |
| 1982157962 | Seasons Dental | Dentist | 425 N Overland Ave, Burley, ID 83318-3434 | 2016-07-26 |
| 1619296605 | Brett Jack Lancaster | Dentist | 1361 E 16th St, #2, Burley, ID 83318-2008 | 2010-05-31 |
| Find all providers in BURLEY | ||||
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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.