AVALON DENTAL PC


Address: 672 E Wythe Creek Ct, Ste 101, Kuna, ID 83634-5216
Phone: 2086292800

AVALON DENTAL PC (NPI# 1962850933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962850933
Entity Type Organization
Organization Name AVALON DENTAL PC
Practice Address 672 E Wythe Creek Ct
Ste 101
Kuna
ID 83634-5216
Practice Telephone 2086292800
Practice Fax Number 2086292801
Mailing Telephone 2086292800
Mailing Fax Number 2086292801
Enumeration Date 2016-05-31
Last Update Date 2016-05-31
Authorized Official Name DR. JAMES D. GRANT (OWNER)
Authorized Official Telephone 2086292800
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
D3875 ID Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
ID INDIVIDUAL PROVIDER 1447345491 01

Office Location

Street Address 672 E WYTHE CREEK CT
STE 101
City KUNA
State ID
Zip Code 83634-5216

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477936045 Krystal Reyes Physical Therapist 672 E Wythe Creek Ct, Suite 103, Kuna, ID 83634-5216 2015-07-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780298430 Alliance Medical Group, LLC Family Medicine Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 2020-09-01
1558896506 Nicholas Tock Social Worker 190 W Main Street, Kuna, ID 83634 2017-04-27
1790137073 Jeremy Walker Dentist 1353 N Meridian Rd, Ste 101, Kuna, ID 83634 2016-07-11
1194171678 Kidspeak LLC Occupational Therapist 525b Main St, Kuna, ID 83634 2016-05-13
1447617139 Matt Jordan Nurse Practitioner 13900 South Pleasant Valley Road, Kuna, ID 83634 2016-01-26
1386063980 Colin Brown Physician Assistant 13500 S. Pleasant Valley, Kuna, ID 83634 2014-04-10
1912329806 Brady Tucker Pharmacist 1403 North Meridian Rd, Kuna, ID 83634 2014-01-10
1427489954 Ridley's Family Markets, Inc Pharmacy 1403 N Meridian Rd, Kuna, ID 83634 2013-12-10
1538414354 William Lincoln Poulson Nurse Practitioner 13500 South Pleasant Valley Road, Kuna, ID 83634 2012-07-18
1508036286 Michelle Marie Montoya Counselor 190 W. Main St, Kuna, ID 83634 2008-03-10
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447864384 Kuna Kids Dentistry PC Clinic/Center 1385 N Jacksonmill Ave, Kuna, ID 83634-2042 2020-09-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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
1841643533 Dental Partners Ustick Pllc Clinic/Center 4403 E Ustick Rd # 104, Caldwell, ID 83605-6802 2016-07-18
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Competitor

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City KUNA
Zip Code 83634

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Dataset Information

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.

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