NPI age
2 years
Enumerated 2024-02-26
● Active Type 2 · Organization
Subpart
Id Oms Specialty Dental Services, Pllc
Id Oms Specialty Dental Services, Pllc is 1 of 64 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dasch
Director Of Credentialing And Pr
Last NPPES update
2024-02-26
Source: monthly bulk 2026-05
How this organization compares
Across 64 active dentist providers in Idaho.
NPI age
2 years
↓ 15 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-02Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
7910 W Ustick Rd
Boise, ID 837045850
Mailing address
1610 54th Ave N Ste 205
Nashville, TN 372091442
Authorized official
Charlotte Dasch
Director Of Credentialing And Pr
📞 6156780759
Specialties
-
Dentist PrimaryThe specialty of dentistry which includes 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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Boise Oral Surgery & Implant Center
Practice context
Single-site organization. Only one practice location on file.
Subpart of Id Oms Specialty Dental Services, Pllc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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