OrganizationActive
Whitewater Woodriver Oral Surgery
NPI 1790202810 · Oral and Maxillofacial Surgery Clinic/Center · Hailey, ID
Provider details
- NPI number
- 1790202810
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Marie Berry, Manager(208) 788-5308
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
400 S Main St Ste 202
Hailey, ID 83333-8856
Phone: (208) 788-5308
Street-level locationGet directions
Mailing address
400 S Main St Ste 202
Hailey, ID 83333-8856
Registry dates
- Enumerated
- 2017-08-29
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.