Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
TIMES SQUARE DENTAL
Active
Organization
TIMES SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON R HASTINGS DDS (DENTIST)
(208) 343-1981
Entity
Organization
Contact information
Practice address
1529 S TIMES SQUARE CRT, BOISE, ID 83709
(208) 343-1981
Mailing address
1529 S TIMES SQUARE CRT, STE 100, BOISE, ID 83709
(208) 343-1981
(208) 672-9067
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3254
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804158500
—
ID
Enumeration date
06/05/2008
Last updated
06/05/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers