MILLENNIUM FAMILY DENTAL - BOISE LLC
NPI 1104925064
Dentist - General Practice in Boise, ID

Active since September 21, 2006
813 STILSON RD, SUITE B, BOISE, ID 83703(208) 342-4644(208) 367-0283 Get Directions Write a Review

NPPES record last updated: December 30, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Dentist
  • General Practice

About MILLENNIUM FAMILY DENTAL - BOISE LLC

This page provides the complete NPI Profile along with additional information for Millennium Family Dental - Boise Llc, a provider established in Boise, Idaho operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1104925064 assigned on September 2006. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jennifer Lynn Viquelia (Office Manager)

NPI
1104925064 Verify this NPI
Provider Name
MILLENNIUM FAMILY DENTAL - BOISE LLC
Entity Type
Organization
Location Address
813 STILSON RD SUITE B BOISE, ID 83703
Location Phone
(208) 342-4644
Location Fax
(208) 367-0283
Mailing Address
1848 MILLENIUM WAY MERIDIAN, ID 83642
Mailing Phone
(208) 888-2026
Mailing Fax
(208) 888-2094
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-21-2006
Last Update Date
12-30-2014
Code Navigator

A dentist like Millennium Family Dental - Boise Llc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JENNIFER LYNN VIQUELIA

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(208) 888-2026

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
806766100MEDICAID (05)ID 

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dentist (General Practice)
813 STILSON RD, SUITE A
BOISE, ID 83703
Dentist (Periodontics)
813 STILSON RD, SUITE C
BOISE, ID 83703

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104925064, enumerated as an "organization" on September 21, 2006.

The provider is located at 813 STILSON RD SUITE B BOISE, ID 83703 and the phone number is (208) 342-4644.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.