NPI age
11 years
Enumerated 2015-01-28
● Active Type 2 · Organization
Eagle Oral Surgery And Dental Implant Center Pllc
Eagle Oral Surgery And Dental Implant Center 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
Hixson
Owner/provider
Last NPPES update
2015-01-28
Source: monthly bulk 2026-05
How this organization compares
Across 64 active dentist providers in Idaho.
NPI age
11 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2015 → 2026
2015-01Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
197 W State St
Eagle, ID 836164959
Mailing address
197 W State St
Eagle, ID 836164959
Authorized official
Jeremy L Hixson, DMD
Owner/provider
📞 2084516584
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Shawn Nowierski, MD Family Medicine NPI 1437109089
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.
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 →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.