Healthcare Provider Details

I. General information

NPI: 1861316044
Provider Name (Legal Business Name): HUNSAKER DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5213 W OVERLAND RD
BOISE ID
83705-2637
US

IV. Provider business mailing address

1567 RAYDEAN DR
GRANTS PASS OR
97527-6471
US

V. Phone/Fax

Practice location:
  • Phone: 801-227-4797
  • Fax:
Mailing address:
  • Phone: 801-227-4797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: BROOKS HUNSAKER
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 801-227-4797