MEDICARE: DR. ALEXANDER REIMANN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	100489	CA
2	1223G0001X	General Practice Dentistry	5233	ID

General Provider Information

NPI Number	:	1578916029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER REIMANN DDS

Provider Business Mailing Address
First Line	:	813 N STILSON RD STE B
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83703-5119
Country	:	US
Telephone Number	:	208-342-4644
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 N STILSON RD STE B
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83703-5119
Country	:	US
Telephone Number	:	208-342-4644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	10/09/2024

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Directions to “ DR. ALEXANDER REIMANN DDS” Practice Location

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