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Contact Information

IDAHO PEDIATRIC DENTISTRY
4401 E FLAMINGO AVE
NAMPA, ID83687-3113
 Phone: 208-461-5459
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Special Hospital

284300000X A0[7] Hospital-Specialty Hospital (cardiac, orthopedic, surgical)
Indicates primary specialty

NPI Profile & details for IDAHO PEDIATRIC DENTISTRY

NPI Number 1659530103
LBN Legal business name IDAHO PEDIATRIC DENTISTRY
Authorized official KATHI NELSON - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/09/2008
Last updated 06/09/2008 - About 18 years ago
Identifiers
ID License # D3936PD
ID Medicaid 805011445
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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