MOUNTAIN HOME DENTAL PC – NPI #1801437447
Clinic/Center

MOUNTAIN HOME DENTAL PC is an AHC clinic located in MOUNTAIN HOME, ID. NPPES has assigned the NPI number 1801437447 to MOUNTAIN HOME DENTAL PC on October 04, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 6 years ago on Jan 21, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MOUNTAIN HOME DENTAL PC below.

NPI Profile for
MOUNTAIN HOME DENTAL PC

NPI Number
1801437447
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MOUNTAIN HOME DENTAL PC
Primary location
455 N 3RD E
MOUNTAIN HOME, ID 83647
Phone: (208) 587-2625 Fax:
Mailing address
685 N 4TH E
MOUNTAIN HOME, ID 83647-2134
Phone: (208) 599-3189 Fax:
Organization Subpart
No
Authorized Official
JARED SEXAUER
DENTIST
Phone: (208) 599-3189
Updated
Certification Date
Jan 21, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.