OrganizationActive
Southridge Dental
NPI 1003010877 · General Practice Dentistry · Nampa, ID
Southridge Dental is a General Practice Dentistry organization in Nampa, ID (NPI 1003010877).
Provider details
- NPI number
- 1003010877
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Robert Pratt, Dentist(208) 466-2458
- License
- D3499 (ID)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2811 12th Ave Rd
Nampa, ID 83686-8482
Phone: (208) 466-2458
Fax: (208) 465-6303
Street-level locationGet directions
Mailing address
2811 12th Ave Rd
Nampa, ID 83686-8482
Registry dates
- Enumerated
- 2007-06-13
- Last updated
- 2020-08-22
Frequently asked questions
- What is Southridge Dental's NPI number?
- Southridge Dental's National Provider Identifier (NPI) is 1003010877, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southridge Dental?
- Southridge Dental is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Southridge Dental located?
- Southridge Dental's practice location on file with NPPES is 2811 12th Ave Rd, Nampa, ID 83686-8482.
- What is Southridge Dental's phone number?
- The practice phone number listed in the NPPES registry for Southridge Dental is (208) 466-2458.
- Who is the authorized official for Southridge Dental?
- The authorized official listed on Southridge Dental's NPPES record is Robert Pratt, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southridge Dental's NPI active?
- Yes — Southridge Dental's NPI (1003010877) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.