Idaho Dental Professionals, P.C.
NPI 1760162812ActiveOrganization· Dentist, General Practice· Boise, ID
Dentist, General Practice in Boise, Idaho, registered in NPPES in July 2023, part of Idaho Dental Professionals, P.C. The authorized official on file is Cemyira McDougal, Credentialing Coordinator.
Overview
| NPI | 1760162812 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Idaho Dental Professionals, P.C. |
| NPI issued | Jul 24, 2023 |
| Last updated in NPPES | Jul 24, 2023 |
| Certified by provider | Jul 24, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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