ROBERT O STEVENS DMD PA NPI 1336220144

NPI Information

NPI: 1336220144
Provider Name: ROBERT O STEVENS DMD, PA

Former Legal Business Name: BETHEL DENTAL GROUP

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
10572 W BUSINESS PARK LN
BOISE, ID
ZIP 83709
Phone: (208) 375-5656
Get Directions

ROBERT O STEVENS DMD, PA is a dental clinic center in Boise, ID. ROBERT O STEVENS DMD, PA NPI is 1336220144. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Bethel Dental Group.

The provider's business location address is:

10572 W BUSINESS PARK LN
BOISE, ID
ZIP 83709-797
Phone: (208) 375-5656
Fax: (208) 375-5928

The provider's authorized official is Robert Orlo Stevens .
The authorized official title is Dentist Owner and has the following contact phone number (208) 375-5656.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 5/13/2013.

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	261QD0000X	Clinic/Center	Dental	D1807	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	43162	OTHER	IDAHO	REGENCE BLUE SHIELD
2	64709	OTHER	IDAHO	BLUE CROSS

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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