NICHOLAS A MASSOTH D.M.D. NPI 1114957917

NPI Information

  • NPI: 1114957917
  • Provider Name: NICHOLAS A MASSOTH, D.M.D.
  • Classification: Dentist - 1223P0106X
  • Specialization: Oral and Maxillofacial Pathology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4121 CLOCK TOWER AVE
    CALDWELL, ID
    ZIP 83607
  • Phone: (208) 459-7800

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NPI Details

Nicholas A Massoth, D.M.D. is an oral and maxillofacial pathology dentist in Caldwell, ID. The provider is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. Nicholas A Massoth, D.M.D. NPI is 1114957917. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4121 CLOCK TOWER AVE
CALDWELL, ID
ZIP 83607-006
Phone: (208) 459-7800
Fax: (208) 455-8452

The NPI 1114957917 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/4/2006 and was last updated on 7/9/2007.

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
11223P0106XDentistOral and Maxillofacial PathologyD 3848 OSIDAHOYes

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: 3/30/2025

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