NPI age
19 years
Enumerated 2007-06-13
● Active Type 2 · Organization
Southridge Dental
Southridge Dental is 1 of 1,126 general practice (dentist) organizations in Idaho.
Primary specialty
General Practice (Dentist)
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Pratt
Dentist
Last NPPES update
2020-08-22
Source: CMS NPPES provider record
How this organization compares
Across 1126 active general practice (dentist) providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2020
2007-06Enumerated in NPPES
2007
2020
Where they practice
Primary practice location
2811 12th Ave Rd
Nampa, ID 836868482
Mailing address
2811 12th Ave Rd
Nampa, ID 836868482
Authorized official
Robert Alan Pratt, D.M.D.
Dentist
📞 2084662458
Other providers sharing this address
2 individual providers use this same primary NPPES address. Address matching does not prove employment or organizational affiliation.
- Shawn Lee, D.M.D. Dentist NPI 1962714139
- Todd Squires, DDS Dentist NPI 1063894145
Specialties
-
Dentist PrimaryA 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.
Practice context
Shared NPPES address. 2 individual providers use this primary address. This does not prove employment or affiliation.
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