MRS. BONNIE JEAN DEVALL LICENSED DENTURIST NPI 1720124324

NPI Information

NPI: 1720124324
Provider Name: MRS. BONNIE JEAN DEVALL, LICENSED DENTURIST
Classification: Denturist - 122400000X
Entity Type: Individual
Address:
507 MAIN AVE W
SUITE B
TWIN FALLS, ID
ZIP 83301
Phone: (208) 733-2374
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MRS. Bonnie Jean Devall, LICENSED DENTURIST is a denturist in Twin Falls, ID. The provider is a denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. MRS. Bonnie Jean Devall, LICENSED DENTURIST NPI is 1720124324. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

507 MAIN AVE W
SUITE B
TWIN FALLS, ID
ZIP 83301
Phone: (208) 733-2374

The enumeration date for this NPI number is 1/30/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122400000X	Denturist		LD18	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001191300	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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