BRYCE D HANSON DMD PA NPI 1851798045

NPI Information

NPI: 1851798045
Provider Name: BRYCE D HANSON, DMD PA
Classification: Clinic/Center - 261QD0000X
Specialization: Dental
Entity Type: Organization
Doing Business As: RIVER VALLEY DENTAL CARE
Address: 371 W FIR ST
SHELLEY, ID
ZIP 83274
Phone: (208) 357-7611

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NPI Details

BRYCE D HANSON, DMD PA is a dental clinic center in Shelley, ID. BRYCE D HANSON, DMD PA NPI is 1851798045. The provider is registered as an organization entity type.
The provider Is Doing Business As River Valley Dental Care.

The provider's business location address is:

371 W FIR ST
SHELLEY, ID
ZIP 83274-456
Phone: (208) 357-7611
Fax: (208) 357-1805

The provider's authorized official is Bryce D Hanson .
The authorized official title is Owner and has the following contact phone number (208) 357-7611.

The enumeration date for this NPI number is 12/3/2014 and was last updated on 12/3/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	D-3275	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
1	0025-57200	MEDICAID	IDAHO
2	119-477-4109	MEDICAID	IDAHO
3	8050-31700	MEDICAID	IDAHO

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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