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KEMP DENTAL LLC NPI 1255503777


NPI Information

NPI: 1255503777
Provider Name: KEMP DENTAL LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1541 E CLARK ST
POCATELLO, ID
ZIP 83201
Phone: (208) 232-6400
Get Directions

KEMP DENTAL LLC is a general practice dentist in Pocatello, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. KEMP DENTAL LLC NPI is 1255503777. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1541 E CLARK ST
POCATELLO, ID
ZIP 83201-100
Phone: (208) 232-6400
Fax: (208) 232-6050

The provider's authorized official is Sid Ellis Hedges .
The authorized official title is Practice Administrator and has the following contact phone number (208) 232-6400.

The enumeration date for this NPI number is 3/25/2008 and was last updated on 3/25/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeD-1783IDAHOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10025307MEDICAIDIDAHO

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: 11/14/2023

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