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EAGLE ORAL SURGERY AND DENTAL IMPLANT CENTER PLLC
NPI 1780074864
Dentist - Oral and Maxillofacial Surgery in Eagle, ID

Active since January 28, 2015
197 W STATE ST, EAGLE, ID 83616(208) 995-2865 Get Directions Write a Review

NPPES record last updated: January 28, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eagle Oral Surgery And Dental Implant Center Pllc NPPES

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

EAGLE ORAL SURGERY AND DENTAL IMPLANT CENTER PLLC (NPI 1780074864) is a healthcare organization registered as an oral and maxillofacial surgery in Eagle, Idaho and active in the NPI registry since January 2015. The organization lists Jeremy L Hixson, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1780074864
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameEAGLE ORAL SURGERY AND DENTAL IMPLANT CENTER PLLC
Location Address197 W STATE STEagle, ID 83616-4959
Mailing Address197 W State StEagle, ID 83616-4959 · (208) 995-2865
Phone(208) 995-2865
Organization SubpartNo
Authorized OfficialJeremy L HixsonOwner/provider · (208) 451-6584
Enumeration DateJanuary 28, 2015
✔ NPI 1780074864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in ID · D-4617-OS
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
197 W STATE ST, Eagle, ID 83616
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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. SHAWN CHRISTIAN NOWIERSKI MD
Family Medicine
197 W STATE ST
EAGLE, ID 83616
Ada County (208) 938-9817

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 Eagle Oral Surgery And Dental Implant Center PLLC's NPI number?

The NPI number for Eagle Oral Surgery And Dental Implant Center PLLC is 1780074864. It was assigned to this organization in the NPPES registry on January 28, 2015.

Where is Eagle Oral Surgery And Dental Implant Center PLLC located?

Eagle Oral Surgery And Dental Implant Center PLLC is located at 197 W State St, Eagle, ID 83616. The listed phone number is (208) 995-2865.

What is Eagle Oral Surgery And Dental Implant Center PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does Eagle Oral Surgery And Dental Implant Center PLLC accept?

Health plans from UnitedHealthcare list Eagle Oral Surgery And Dental Implant Center PLLC 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 Eagle Oral Surgery And Dental Implant Center PLLC was last updated on January 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.