Healthcare Provider Details

I. General information

NPI: 1972487346
Provider Name (Legal Business Name): PARKER KUHN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 S WELLS ST
MERIDIAN ID
83642-7997
US

IV. Provider business mailing address

1176 E KINSWOOD ST
IDAHO FALLS ID
83404-5092
US

V. Phone/Fax

Practice location:
  • Phone: 855-433-6825
  • Fax:
Mailing address:
  • Phone: 208-604-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1071175
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: