Healthcare Provider Details

I. General information

NPI: 1720297070
Provider Name (Legal Business Name): DIDEHBANS LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 W EMERALD ST #105
BOISE ID
83704
US

IV. Provider business mailing address

7447 W EMERALD ST #105
BOISE ID
83704
US

V. Phone/Fax

Practice location:
  • Phone: 208-322-1642
  • Fax: 208-378-4178
Mailing address:
  • Phone: 208-322-1642
  • Fax: 208-378-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License NumberA7965
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number25009
License Number StateIL

VIII. Authorized Official

Name: MRS. SUE DIDEHBAN
Title or Position: PRESIDENT OWNER FRANCHASIE
Credential:
Phone: 208-461-1000