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DR. KIMBALL GRAY MACK DMD
NPI 1659809200
Dentist - General Practice in Boise, ID

Active since May 26, 2017
4255 N EAGLE RD STE 102, BOISE, ID 83713(208) 344-6300(082) 938-9906 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 12, 2024, Jul 21, 2022, May 26, 2017 (3 updates tracked since 2017).

About Dr. Kimball Gray Mack Dmd NPPES

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

DR. KIMBALL GRAY MACK DMD (NPI 1659809200) is an individual general practice provider in Boise, Idaho, licensed in Idaho (D5587) and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1659809200
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KIMBALL GRAY MACKCredential: DMD
Location Address4255 N EAGLE RD STE 102Boise, ID 83713-0701
Mailing Address4255 N Eagle Rd Ste 102Boise, ID 83713-0701 · (208) 344-6300 · Fax (208) 938-9906
Phone(208) 344-6300
Fax(082) 938-9906
Sole ProprietorYes
Enumeration DateMay 26, 2017
Last NPPES UpdateAugust 28, 20253 updates tracked since enumeration
NPPES CertifiedAugust 28, 2025
✔ NPI 1659809200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in ID · D5587
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.
4255 N EAGLE RD STE 102, Boise, ID 83713
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

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.

DR. BRYAN H LAMB DMD
Dentist
4255 N EAGLE RD STE 102
BOISE, ID 83713
Ada County (208) 344-6300
DR. BRANT BURBANK DDS
Dentist (General Practice)
4255 N EAGLE RD STE 102
BOISE, ID 83713
Ada County (208) 344-6300

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 Kimball Mack's NPI number?

The NPI number for Kimball Mack is 1659809200. It was assigned to this individual provider in the NPPES registry on May 26, 2017.

Where is Kimball Mack located?

Kimball Mack practices at 4255 N Eagle Rd Ste 102, Boise, ID 83713. The listed phone number is (208) 344-6300.

What is Kimball Mack's specialty?

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

What insurance does Kimball Mack accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 6 other insurers list Kimball Mack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimball Mack was last updated on August 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.