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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KEATON NICHOLSON
NPI 1902749864
Dentist - Periodontics in Boise, ID

Active since April 13, 2026
140 E BOISE AVE, BOISE, ID 83706(208) 385-9228 Get Directions Write a Review

NPPES record last updated: August 17, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 17, 2026, Apr 13, 2026 (2 updates tracked since 2026).

About Keaton Nicholson NPPES

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

KEATON NICHOLSON (NPI 1902749864) is an individual periodontics provider in Boise, Idaho, licensed in Idaho (1781902) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1902749864
Entity TypeIndividual
Primary Taxonomy1223P0300X
Provider Legal NameKEATON NICHOLSON
Location Address140 E BOISE AVEBoise, ID 83706-4302
Mailing Address140 E Boise AveBoise, ID 83706-4302
Phone(208) 385-9228
Sole ProprietorNo
Enumeration DateApril 13, 2026
Last NPPES UpdateAugust 17, 20262 updates tracked since enumeration
NPPES CertifiedAugust 17, 2026
✔ NPI 1902749864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in ID · 1781902
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
140 E BOISE AVE, Boise, ID 83706
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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.

RANDY DEMETTER DDS
Dentist (Periodontics)
140 E BOISE AVE
BOISE, ID 83706
Ada County (208) 385-9228
DR. JACK H LINCKS DDS, MS
Dentist (Periodontics)
140 E BOISE AVE
BOISE, ID 83706
Ada County (208) 385-9228
DR. STEPHEN A. MORRIS D.D.S. M.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
140 E BOISE AVE, SUITE B
BOISE, ID 83706
Ada County (208) 344-4334
DR. JOHN HOWELL MUMFORD D.M.D.
Dentist (Periodontics)
140 E BOISE AVE
BOISE, ID 83706
Ada County (208) 385-9228
PERIODONTAL HEALTH SPECIALISTS OF IDAHO
Dentist (Periodontics)
140 E BOISE AVE
BOISE, ID 83706
Ada County (208) 385-9228
STEPHEN A. MORRIS
Dentist (Orthodontics and Dentofacial Orthopedics)
140 E BOISE AVE, SUITE B
BOISE, ID 83706
Ada County (208) 344-4334

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 Keaton Nicholson's NPI number?

The NPI number for Keaton Nicholson is 1902749864. It was assigned to this individual provider in the NPPES registry on April 13, 2026.

Where is Keaton Nicholson located?

Keaton Nicholson practices at 140 E Boise Ave, Boise, ID 83706. The listed phone number is (208) 385-9228.

What is Keaton Nicholson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Keaton Nicholson was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.