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WHITEWATER WOODRIVER ORAL SURGERY
NPI 1790202810
Clinic/Center - Oral and Maxillofacial Surgery in Hailey, ID

Active since August 29, 2017
400 S MAIN ST STE 202, HAILEY, ID 83333(208) 788-5308 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Aug 29, 2017 (2 updates tracked since 2017).

About Whitewater Woodriver Oral Surgery NPPES

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

WHITEWATER WOODRIVER ORAL SURGERY (NPI 1790202810) is a healthcare organization registered as an oral and maxillofacial surgery in Hailey, Idaho and active in the NPI registry since August 2017. The organization lists Marie E Berry, Manager, as its authorized official.

NPPES Registry Identity

NPI1790202810
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameWHITEWATER WOODRIVER ORAL SURGERY
Location Address400 S MAIN ST STE 202Hailey, ID 83333-8856
Mailing Address400 S Main St Ste 202Hailey, ID 83333-8856 · (208) 788-5308
Phone(208) 788-5308
Organization SubpartNo
Authorized OfficialMarie E BerryManager · (208) 788-5308
Enumeration DateAugust 29, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1790202810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
Definition

An oral and maxillofacial surgery clinic or center 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.

400 S MAIN ST STE 202, Hailey, ID 83333
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Other Providers at the Same Location NPPES

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

SAWTOOTH PERIODONTICS PLLC
Dentist (Periodontics)
400 S MAIN ST STE 202
HAILEY, ID 83333
Blaine County (208) 971-4989

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 Whitewater Woodriver Oral Surgery's NPI number?

The NPI number for Whitewater Woodriver Oral Surgery is 1790202810. It was assigned to this organization in the NPPES registry on August 29, 2017.

Where is Whitewater Woodriver Oral Surgery located?

Whitewater Woodriver Oral Surgery is located at 400 S Main St Ste 202, Hailey, ID 83333. The listed phone number is (208) 788-5308.

What is Whitewater Woodriver Oral Surgery's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Oral and Maxillofacial Surgery, with taxonomy code 261QS0112X.

When was this NPI record last updated?

The NPPES record for Whitewater Woodriver Oral Surgery was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.