PREMIER DENTISTRY OF EAGLE
NPI 1649620139
Clinic/Center - Dental in Eagle, ID
About Premier Dentistry Of Eagle NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIER DENTISTRY OF EAGLE (NPI 1649620139) is a healthcare organization registered as a dental in Eagle, Idaho and active in the NPI registry since June 2016. The organization lists Shane Steven Porter, Dentist/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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.
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 Idaho Innovative Dentistry, PLLC's NPI number?
The NPI number for Idaho Innovative Dentistry, PLLC is 1649620139. It was assigned to this organization in the NPPES registry on June 15, 2016. The provider is doing business as Premier Dentistry Of Eagle.
Where is Idaho Innovative Dentistry, PLLC located?
Idaho Innovative Dentistry, PLLC is located at 467 S Rivershore Ln, Eagle, ID 83616. The listed phone number is (208) 938-1247.
What is Idaho Innovative Dentistry, PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.
When was this NPI record last updated?
The NPPES record for Idaho Innovative Dentistry, PLLC was last updated on June 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Premier Dentistry Of Eagle · NPI 1649620139
Dental organization in Eagle, Idaho. Organization record, active in the CMS NPPES registry since June 15, 2016.
## Identity
- **NPI:** 1649620139 (Entity type: Organization)
- **Enumerated:** June 15, 2016
- **Primary specialty:** Clinic/Center - Dental · taxonomy 261QD0000X
- **Legal business name:** Idaho Innovative Dentistry, Pllc
- **Organization subpart:** No
- **Authorized official:** Shane Porter, DENTIST/OWNER
## Practice location
- **Address:** 467 S RIVERSHORE LN, Eagle, ID 83616-4978
- **Phone:** (208) 938-1247
## Record status
- **NPPES last updated:** June 15, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1649620139) · Data from the CMS NPPES public registry.