OrganizationActive
Southridge Dental
NPI 1891954343 · General Practice Dentistry · Nampa, ID
Provider details
- NPI number
- 1891954343
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Robert Pratt, Dentist(208) 466-2458
- License
- D-3499 (ID)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
- 2008-06-09
- Last updated
- 2008-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.