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General NPI Number Information
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NPI Number | 1053210161
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Entity Type | Organization
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Legal Business Name | BIGFOOT ENDODONTICS PLLC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 1788 W MCMILLAN RD
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City | MERIDIAN
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State | ID
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Zip | 83646
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Country | US
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Telephone | 208-640-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 5265 N DIAMOND CREEK AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-6484
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. BRANDON ASTIN
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Credential | DMD
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Telephone | 208-640-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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