Organization provider
SOUTHRIDGE DENTAL
CMS NPPES lists SOUTHRIDGE DENTAL as an organization provider record with NPI 1003010877. The current record reports a primary practice location in NAMPA, ID and primary taxonomy code 1223G0001X.
Type 2 NPIs identify organizations such as practices, groups, and facilities; the NPI type alone does not establish a specific organization category. How to read this profile
01
Practice locations
- Primary practice location2811 12TH AVE RDNAMPA, ID 836868482
Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.
02
Taxonomy information
1223G0001XPrimary reported taxonomy
Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.
03
NPI record information
- NPI status
- Enumerated in NPPES
- Enumeration date
- June 13, 2007
An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.