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PHEASANT COVE DENTAL
NPI 1770769325
Dentist - General Practice in Kimberly, ID

Active since January 14, 2008
702 CENTER ST W, KIMBERLY, ID 83341(208) 423-6444(208) 423-6903 Get Directions Write a Review

NPPES record last updated: January 14, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pheasant Cove Dental NPPES

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

PHEASANT COVE DENTAL (NPI 1770769325) is a healthcare organization registered as a general practice in Kimberly, Idaho and active in the NPI registry since January 2008. The organization lists Kent J Allen, Owner, as its authorized official.

NPPES Registry Identity

NPI1770769325
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKENT J ALLEN/ SHANNON WIDMIER
Location Address702 CENTER ST WKimberly, ID 83341
Mailing Address702 Center Street West, Po Box BKimberly, ID 83341 · (208) 423-6444
Phone(208) 423-6444
Fax(208) 423-6903
Organization SubpartNo
Authorized OfficialKent J AllenOwner · (208) 423-6444
Enumeration DateJanuary 14, 2008
✔ NPI 1770769325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · D1767
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.
702 CENTER ST W, Kimberly, ID 83341
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Other Names 1

Doing Business AsPheasant Cove Dental

Other Identifiers 2

Medicaid000876700ID
Other9201818ID · Smiles

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

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

DR. DANTON LAFEY BRADSHAW D.D.S.
Dentist
702 CENTER ST W
KIMBERLY, ID 83341
Twin Falls County (208) 423-6444

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 Kent J Allen/ Shannon Widmier's NPI number?

The NPI number for Kent J Allen/ Shannon Widmier is 1770769325. It was assigned to this organization in the NPPES registry on January 14, 2008. The provider is doing business as Pheasant Cove Dental.

Where is Kent J Allen/ Shannon Widmier located?

Kent J Allen/ Shannon Widmier is located at 702 Center St W, Kimberly, ID 83341. The listed phone number is (208) 423-6444.

What is Kent J Allen/ Shannon Widmier'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 Kent J Allen/ Shannon Widmier was last updated on January 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.