BOISE ENT LLC NPI 1174108674

NPI Information

  • NPI: 1174108674
  • Provider Name: BOISE ENT, LLC
  • Classification: Otolaryngology - 207YS0123X
  • Specialization: Facial Plastic Surgery
  • Entity Type: Organization
  • Former Legal Business Name: DONALD J BEASLEY SOLE MBR
  • Address: 8854 W EMERALD ST STE 150
    BOISE, ID
    ZIP 83704
  • Phone: (208) 229-2368

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NPI Details

BOISE ENT, LLC is a facial plastic surgery otolaryngology in Boise, ID. The provider is an otolaryngologist who specializes in facial plastic surgery. BOISE ENT, LLC NPI is 1174108674. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Donald J Beasley Sole Mbr.

The provider's business location address is:

8854 W EMERALD ST STE 150
BOISE, ID
ZIP 83704-844
Phone: (208) 229-2368

The provider's authorized official is Donald J Beasley .
The authorized official title is Owner and has the following contact phone number (208) 229-2368.

The enumeration date for this NPI number is 3/16/2021 and was last updated on 5/25/2021.

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
1207YS0123XOtolaryngologyFacial Plastic SurgeryYes

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: 11/21/2025

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