Dermatology
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Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1407704356 · enumerated 2026-03-17 · record updated 2026-03-17. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Mailing address 756 S LANDORE AVE, KUNA, ID, 83634-5062 (208) 908-7081 Google Maps Apple Maps OpenStreetMap
- Practice location 13162 W PERSIMMON LN, BOISE, ID, 83713-1986 (208) 908-7081 Google Maps Apple Maps OpenStreetMap
Specialties
- Dermatology 207N00000X · Primary · License 8371268 ID
In this directory
Locations and evidence
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Practice location
BOISE, ID, 837131986
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.