NPI age
18 years
Enumerated 2007-07-02
● Active Type 2 · Organization
Canyon County Oral Maxillofacial Surgery, Inc
Canyon County Oral Maxillofacial Surgery, Inc is 1 of 5 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Massoth
Oral Surgeon
Last NPPES update
2007-07-10
Source: monthly bulk 2026-05
How this organization compares
Across 5 active dentist providers in Idaho.
NPI age
18 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-07Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
4121 Clock Tower Ave
Caldwell, ID 836075006
Mailing address
4121 Clock Tower Ave
Caldwell, ID 836075006
Authorized official
Nicholas A Massoth, DMD
Oral Surgeon
📞 2084597800
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Nicholas Massoth, D.M.D. Dentist NPI 1114957917
Specialties
-
Dentist PrimaryThe specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 10149985 | REGENCE BLUE SHIELD |
| 01 (ID) | 1783151 | UNITED CONCORDIA |
| 01 (ID) | 6L859 | BLUE CROSS OF ID |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Canyon County Oral Maxillofacial Surgery
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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