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CLUB 32 DENTAL CALDWELL PLLC
NPI 1033796305
Dentist - General Practice in Caldwell, ID

Active since March 24, 2021
1916 ELLIS AVE, CALDWELL, ID 83605(208) 466-2456 Get Directions Write a Review

NPPES record last updated: March 10, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 10, 2022, Mar 24, 2021 (2 updates tracked since 2021).

About Club 32 Dental Caldwell Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLUB 32 DENTAL CALDWELL PLLC (NPI 1033796305) is a healthcare organization registered as a general practice in Caldwell, Idaho and active in the NPI registry since March 2021. The organization lists Kim Keller, Owner, as its authorized official.

NPPES Registry Identity

NPI1033796305
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCLUB 32 DENTAL CALDWELL PLLC
Location Address1916 ELLIS AVECaldwell, ID 83605-4811
Mailing Address624 3rd St SNampa, ID 83651-3840 · (208) 506-3233
Phone(208) 466-2456
Organization SubpartNo
Authorized OfficialKim KellerOwner · (208) 506-3233
Enumeration DateMarch 24, 2021
Last NPPES UpdateMarch 10, 20222 updates tracked since enumeration
NPPES CertifiedMarch 10, 2022
✔ NPI 1033796305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1916 ELLIS AVE, Caldwell, ID 83605
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TODAYS DENTISTRY CALDWELL WEST PLLC
Clinic/Center (Dental)
1916 ELLIS AVE
CALDWELL, ID 83605
Canyon County (208) 459-8505
THOMAS LAGRAND BLAISDELL D.D.S.
Dentist (General Practice)
1916 ELLIS AVE
CALDWELL, ID 83605
Canyon County (208) 459-2376
DR. JOHN DAVID BLAISDELL D.D.S.
Dentist
1916 ELLIS AVE
CALDWELL, ID 83605
Canyon County (208) 459-2376
BLAISDELL DENTAL CENTER, PA
Dentist (General Practice)
1916 ELLIS AVE
CALDWELL, ID 83605
Canyon County (208) 459-2376

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Club 32 Dental Caldwell PLLC's NPI number?

The NPI number for Club 32 Dental Caldwell PLLC is 1033796305. It was assigned to this organization in the NPPES registry on March 24, 2021.

Where is Club 32 Dental Caldwell PLLC located?

Club 32 Dental Caldwell PLLC is located at 1916 Ellis Ave, Caldwell, ID 83605. The listed phone number is (208) 466-2456.

What is Club 32 Dental Caldwell PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Club 32 Dental Caldwell PLLC was last updated on March 10, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.