Table Rock Oral Surgery PLLC
NPI 1487238689 · Oral and Maxillofacial Surgery Clinic/Center · Boise, ID
Table Rock Oral Surgery PLLC is a Oral and Maxillofacial Surgery Clinic/Center organization in Boise, ID (NPI 1487238689).
Provider details
- NPI number
- 1487238689
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Timothy Obrien, Owner(208) 412-0637
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
Mailing address
Other names (DBA / former)
- Doing business as
- Table Rock Oral Surgery and Dental Implants
Registry dates
- Enumerated
- 2021-05-12
- Last updated
- 2024-04-10
- Certified
- 2024-04-10
Frequently asked questions
- What is Table Rock Oral Surgery PLLC's NPI number?
- Table Rock Oral Surgery PLLC's National Provider Identifier (NPI) is 1487238689, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Table Rock Oral Surgery PLLC?
- Table Rock Oral Surgery PLLC is classified in the NPPES registry as Oral and Maxillofacial Surgery Clinic/Center (Ambulatory Health Care Facilities).
- Where is Table Rock Oral Surgery PLLC located?
- Table Rock Oral Surgery PLLC's practice location on file with NPPES is 403 S 11th St Ste 320, Boise, ID 83702-6968.
- What is Table Rock Oral Surgery PLLC's phone number?
- The practice phone number listed in the NPPES registry for Table Rock Oral Surgery PLLC is (208) 375-0191.
- Who is the authorized official for Table Rock Oral Surgery PLLC?
- The authorized official listed on Table Rock Oral Surgery PLLC's NPPES record is Timothy Obrien, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Table Rock Oral Surgery PLLC's NPI active?
- Yes — Table Rock Oral Surgery PLLC's NPI (1487238689) is active in the NPPES registry as of the last update on 2024-04-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.