BRADEN M. STAUTS DDS LLC NPI 1386899987

NPI Information

NPI: 1386899987
Provider Name: BRADEN M. STAUTS DDS LLC

Former Legal Business Name: BRADEN STAUTS DDS

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

Specialization: Dental

Address:
1000 N CURTIS RD
SUITE 203
BOISE, ID
ZIP 83706
Phone: (208) 376-0567
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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
1	261QD0000X	Clinic/Center	Dental	D-2083-PR	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	1204123	MEDICARE UPIN	IDAHO
2	1578588364	OTHER	IDAHO	PERSONAL 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: 4/28/2024

NPI Synchronization or Removal

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