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SOUTHRIDGE DENTAL
NPI 1891954343
Dentist - General Practice in Nampa, ID

Active since June 09, 2008
2811 12TH AVE RD, NAMPA, ID 83686(208) 466-2458(208) 465-6303 Get Directions Write a Review

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southridge Dental NPPES

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

SOUTHRIDGE DENTAL (NPI 1891954343) is a healthcare organization registered as a general practice in Nampa, Idaho and active in the NPI registry since June 2008. The organization lists Robert Alan Pratt, Dentist, as its authorized official.

NPPES Registry Identity

NPI1891954343
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHRIDGE DENTAL
Location Address2811 12TH AVE RDNampa, ID 83686-8482
Mailing Address2811 12th Ave RdNampa, ID 83686-8482 · (208) 466-2458 · Fax (208) 465-6303
Phone(208) 466-2458
Fax(208) 465-6303
Organization SubpartNo
Authorized OfficialRobert Alan PrattDentist · (208) 466-2458
Enumeration DateJune 9, 2008
Last NPPES UpdateJune 18, 2008
✔ NPI 1891954343 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 · D-3499
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.
2811 12TH AVE RD, Nampa, ID 83686
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

SOUTHRIDGE DENTAL
Dentist (General Practice)
2811 12TH AVE RD
NAMPA, ID 83686
Canyon County (208) 466-2458
TODD SQUIRES DDS
Dentist (General Practice)
2811 12TH AVE RD
NAMPA, ID 83686
Canyon County (208) 466-2458
SLEEP RIGHT IDAHO PLLC
Dentist (General Practice)
2811 12TH AVE RD
NAMPA, ID 83686
Canyon County (208) 466-2458
TODD L SQUIRES DDC PLLC
Dentist (General Practice)
2811 12TH AVE RD
NAMPA, ID 83686
Canyon County (208) 466-2458
KELLY E. CARLEN, DDS PLLC
Clinic/Center (Dental)
2811 12TH AVE RD
NAMPA, ID 83686
Canyon County (208) 461-1060
DR. SHAWN D LEE D.M.D.
Dentist (General Practice)
2811 12TH AVE RD
NAMPA, ID 83686
Canyon County (208) 466-2458

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 Southridge Dental's NPI number?

The NPI number for Southridge Dental is 1891954343. It was assigned to this organization in the NPPES registry on June 9, 2008.

Where is Southridge Dental located?

Southridge Dental is located at 2811 12th Ave Rd, Nampa, ID 83686. The listed phone number is (208) 466-2458.

What is Southridge Dental'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 Southridge Dental was last updated on June 18, 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.