# RICKHEIM, DDS, MS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RICKHEIM, DDS, MS, PLLC
- **Other names:** Timberline Oral Surgery & Dental Implants
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811883291
- **Legal business name:** RICKHEIM, DDS, MS, PLLC
- **Authorized official:** CASSIE WIETH (DIRECTOR OF PAYOR RELATIONS)
- **Authorized official phone:** (623) 267-8121

## Contact information

- **Practice address:** 1701 W PRAIRIE AVE STE 103, HAYDEN, ID 83835-8421
- **Practice address phone:** (208) 216-0373
- **Mailing address:** 1701 W PRAIRIE AVE STE 103, HAYDEN, ID 83835-8421
- **Mailing address phone:** (208) 216-0373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/13/2025
- **Last updated:** 06/13/2025