BRADEN M. STAUTS DDS LLC NPI 1386899987

NPI Information

  • NPI: 1386899987
  • Provider Name: BRADEN M. STAUTS DDS LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Former Legal Business Name: BRADEN STAUTS DDS
  • Address: 1000 N CURTIS RD
    SUITE 203
    BOISE, ID
    ZIP 83706
  • Phone: (208) 376-0567

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NPI Details

BRADEN M. STAUTS DDS LLC is a dental clinic center in Boise, ID. BRADEN M. STAUTS DDS LLC NPI is 1386899987. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Braden Stauts Dds.

The provider's business location address is:

1000 N CURTIS RD
SUITE 203
BOISE, ID
ZIP 83706-337
Phone: (208) 376-0567

The provider's authorized official is Braden M Stauts .
The authorized official title is Owner and has the following contact phone number (208) 376-0567.

The enumeration date for this NPI number is 11/24/2008 and was last updated on 11/24/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalD-2083-PRIDAHOYes

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
11204123MEDICARE UPINIDAHO
21578588364OTHERIDAHOPERSONAL NPI

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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