Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1801406731 Individual Practitioner Male Practitioner

Dr. Calvin Tyler Skinner , DDS

Dentist - General Practice • Boise, ID

Professional Overview & Biography Verified Profile Summary

Dr. Calvin Skinner, DDS is a registered healthcare professional specializing in Dentist - General Practice in Boise, ID. Practice services are available at 1175 E PARKCENTER BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1175 E Parkcenter Blvd

Boise, ID 837066751

Telephone 2088885544
Associated Practice Facility / Clinic
🏢 Action Therapy Facility NPI 1003863457

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Boise, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.3 Yrs
Regional Practice Density
142 Specialists

Practicing in Boise, ID (781 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-01-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License ID 4871762

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist

NUCC Taxonomy Code: 122300000X

State License OR D11305

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

674 Blvd Defrance

Mcrd Parris Island, SC 29905

Phone: 8432283500

144 E Mallard Dr

Boise, ID 837063975

Phone: 2083420315

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Hanna Castleberry , DMD

Dentist - General Practice

NPI 1003594565

Doctor of Dental Medicine

Tanisha Khurana

Dentist - General Practice

NPI 1629769484

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location January 27, 2026

Registered at 1175 E PARKCENTER BLVD, BOISE, ID 837066751 (Tel: 2088885544)

📍
Updated Business Mailing Address January 27, 2026

Registered at 1455 E JADE CREEK ST, EAGLE, ID 836167521 (Tel: 2089870402)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 27, 2026

Dentist (License #4871762 in ID)

📍
Updated Practice Location October 28, 2021

Registered at 674 BLVD DEFRANCE, MCRD PARRIS ISLAND, SC 29905 (Tel: 8432283500)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 28, 2021

Student in an Organized Health Care Education/Training Program

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2020

Dentist (License #D11305 in OR)

NPI Profile Active August 05, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 05, 2020

Registered at 34800 BOB WILSON DRIVE, BUILDING 2, GROUND FLOOR/QUALITY MANAGEMENT SUITE, SAN DIEGO, CA 92134 (Tel: 6195328038)

📍
Updated Business Mailing Address August 05, 2020

Registered at 1306 CALLE VERONA APT 103, CHULA VISTA, CA 919131585 (Tel: 2089870402)

👤
Provider Name / Credentials Updated August 05, 2020

Recorded as CALVIN SKINNER, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 05, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration August 05, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Calvin Skinner. Be the first to share your experience!

Sign in to leave a review for Dr. Calvin Skinner

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1801406731
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 05, 2020
Last Update: January 27, 2026
Sole Proprietor: No

Mailing Address

1455 E Jade Creek St

Eagle, ID 836167521

Phone: 2089870402

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.