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BLAIR PEDIATRIC DENTISTRY PC
NPI 1629483987
Dentist - Pediatric Dentistry in Boise, ID

Active since June 25, 2014
5360 N EAGLE RD, SUITE 103, BOISE, ID 83713(208) 938-9958 Get Directions Write a Review

NPPES record last updated: June 25, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Blair Pediatric Dentistry Pc NPPES

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

BLAIR PEDIATRIC DENTISTRY PC (NPI 1629483987) is a healthcare organization registered as a pediatric dentistry in Boise, Idaho and active in the NPI registry since June 2014. The organization lists Randall P Blair, President, as its authorized official.

NPPES Registry Identity

NPI1629483987
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameBLAIR PEDIATRIC DENTISTRY PC
Location Address5360 N EAGLE RD, SUITE 103Boise, ID 83713-4901
Mailing Address5360 N Eagle Rd, Suite 103Boise, ID 83713-4901 · (208) 938-9958
Phone(208) 938-9958
Organization SubpartNo
Authorized OfficialRandall P BlairPresident · (702) 485-9804
Enumeration DateJune 25, 2014
✔ NPI 1629483987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in ID · D4550PD
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
5360 N EAGLE RD, Boise, ID 83713
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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 2

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

CYNTHIA ANN BRIDGES D.M.D.
Dentist (General Practice)
5360 N EAGLE RD, SUITE 101
BOISE, ID 83713
Ada County (208) 939-7620
DR. VERONICA MONTGOMERY D.D.S.
Dentist (General Practice)
5360 N EAGLE RD, SUITE # 101
BOISE, ID 83713
Ada County (208) 939-7620

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 Blair Pediatric Dentistry PC's NPI number?

The NPI number for Blair Pediatric Dentistry PC is 1629483987. It was assigned to this organization in the NPPES registry on June 25, 2014.

Where is Blair Pediatric Dentistry PC located?

Blair Pediatric Dentistry PC is located at 5360 N Eagle Rd Suite 103, Boise, ID 83713. The listed phone number is (208) 938-9958.

What is Blair Pediatric Dentistry PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Blair Pediatric Dentistry PC was last updated on June 25, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.