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Individual
DR. JOEL R BINGHAM
Active
Individual
DR. JOEL R BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3801
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010012520
BLUE SHIELD OF IDAHO #
ID
01
—
632043
UNITED CONCORDIA PROVIDER
—
01
—
6K141
BLUE CROSS OF ID PROVIDER
ID
05
—
807473900
—
ID
Enumeration date
08/12/2006
Last updated
08/07/2014
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