Ikdo Star LLC
Pediatric Dentistry · Star, ID
Practice location
12190 W Evely Pines LnStar, ID 83669-6126
- Phone
- (208) 884-4466
NPI record
- NPI
- 1861954026
- Entity type
- Organization (Type 2)
- Enumeration date
- April 4, 2019
- Last updated
- May 8, 2020
- Certified
- May 8, 2020
- Organization subpart
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X |
— | — |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X |
— | — |
Mailing address
3289 N Towerbridge WayMeridian, ID 83646-8347
Authorized official
- Name
- Michael D Payne, DMD
- Title
- Owner
- Phone
- (208) 884-4466
About Ikdo Star LLC
Ikdo Star LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Pediatric Dentistry (code 1223P0221X). The practice location is 12190 W Evely Pines Ln, Star, ID 83669-6126. The NPI number 1861954026 was assigned on April 4, 2019 and the record was last updated on May 8, 2020.
The authorized official for this organization is Michael D Payne, DMD, Owner.
Frequently asked questions
What is the NPI number of Ikdo Star LLC?
The NPI number is 1861954026.
What is the phone number of Ikdo Star LLC?
The phone number listed for the practice location is (208) 884-4466.
Where is Ikdo Star LLC located?
12190 W Evely Pines Ln, Star, ID 83669-6126.
What is the taxonomy code for Ikdo Star LLC?
The primary taxonomy code is 1223P0221X – Pediatric Dentistry; 1 more listed above.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
Other Pediatric Dentistry providers in Star
- Mark Olsen, D.D.S.12192 Evely Pines Ln