Individual
DR. JONATHAN BECKET NASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2517 17TH ST, SUITE A, LEWISTON, ID 83501
(208) 746-1373
(208) 746-9855
Mailing address
2517 17TH ST, SUITE A, LEWISTON, ID 83501
(208) 746-1373
(208) 746-9855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3242
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010011285
REGENCE BLUE SHIELD
ID
01
—
149960173
ADA
—
01
—
6A242
BLUE CROSS
ID
05
—
805043900
—
ID
Enumeration date
08/28/2006
Last updated
07/18/2023
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