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BLUE CREEK ENDODONTICS NPI 1417353830


NPI Information

NPI: 1417353830
Provider Name: BLUE CREEK ENDODONTICS
Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

Address:
3240 E LOUISE DR
SUITE 110
MERIDIAN, ID
ZIP 83642
Phone: (208) 578-4700
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BLUE CREEK ENDODONTICS is an endodontics dentist in Meridian, 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. BLUE CREEK ENDODONTICS NPI is 1417353830. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3240 E LOUISE DR
SUITE 110
MERIDIAN, ID
ZIP 83642-107
Phone: (208) 578-4700
Fax: (208) 578-4704

The provider's authorized official is James Anthony Eaton .
The authorized official title is President and has the following contact phone number (901) 267-2294.

The enumeration date for this NPI number is 11/12/2014 and was last updated on 11/12/2014.


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
11223E0200XDentistEndodonticsD-4611-ENIDAHOYes

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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