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NORTHWEST ENDODONTICS PC NPI 1972660769


NPI Information

NPI: 1972660769
Provider Name: NORTHWEST ENDODONTICS PC

Former Legal Business Name: TIMOTHY W PENBERTHY DDS

Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

CLIA Number: 13D2247964

Address:
509 W HANLEY
STE 202
COEUR D ALENE, ID
ZIP 83815
Phone: (208) 667-8622
Get Directions

NORTHWEST ENDODONTICS PC is an endodontics dentist in Coeur D Alene, 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. NORTHWEST ENDODONTICS PC NPI is 1972660769. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Timothy W Penberthy Dds.

The provider's business location address is:

509 W HANLEY
STE 202
COEUR D ALENE, ID
ZIP 83815
Phone: (208) 667-8622
Fax: (208) 664-2402

The provider's authorized official is Timothy Walther Penberthy .
The authorized official title is Owner and has the following contact phone number (208) 667-8622.

The CLIA number assigned to this NPI record is 13D2247964 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2007 and was last updated on 8/4/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223E0200XDentistEndodonticsD1930ENIDAHOYes

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

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