DR. GARY MICHAEL ALTENBURG DDS NPI 1356558852

NPI Information

  • NPI: 1356558852
  • Provider Name: DR. GARY MICHAEL ALTENBURG, DDS
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 450 W STATE ST STE 115
    EAGLE, ID
    ZIP 83616
  • Phone: (208) 286-4200

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NPI Details

DR. Gary Michael Altenburg, DDS is an endodontics dentist in Eagle, ID. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. Gary Michael Altenburg, DDS NPI is 1356558852. 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:

450 W STATE ST STE 115
EAGLE, ID
ZIP 83616-055
Phone: (208) 286-4200
Fax: (208) 286-4201

The NPI 1356558852 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 5/16/2007 and was last updated on 7/7/2022.

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
11223E0200XDentistEndodonticsD-5078-ENIDAHOYes
21223E0200XDentistEndodontics46454CALIFORNIANo

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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