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Active NPI 1972885200 Individual Practitioner Male Practitioner

Dr. Nathaniel A Bork , DMD

Dentist - General Practice • Boise, ID

Professional Overview & Biography Verified Profile Summary

Dr. Nathaniel Bork, DMD is a registered healthcare professional specializing in Dentist - General Practice in Boise, ID. Practice services are available at 2301 N 36TH ST STE 102 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2301 N 36th St Ste 102

Boise, ID 837035202

Telephone 2083368801
Fax 2084665359
Associated Practice Facility / Clinic

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: 2020-01-28
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License ID D-5101

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 - General Practice

NUCC Taxonomy Code: 1223G0001X

State License AZ D008311

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.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Alma Martinez , DMD

Dentist - Prosthodontics

NPI 1023390523

Doctor of Dental Medicine

Dr. Ernest Meshack-Hart , DDS

Dentist - General Practice

NPI 1033138235

Doctor of Dental Surgery

Daniel Lefler , PA

Physician Assistant

NPI 1033620315

Physician Assistant

Mary Goodspeed , PMHNP

Nurse Practitioner

NPI 1053069047

Psychiatric-Mental Health Nurse Practitioner

Dr. Stuart Black , MD

Family Medicine

NPI 1053351361

Doctor of Medicine (M.D.)

Megan George , PA-C

Physician Assistant - Medical

NPI 1053560367

Physician Assistant (Certified)

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location January 28, 2020

Registered at 2301 N 36TH ST STE 102, BOISE, ID 837035202 (Tel: 2083368801)

📍
Updated Business Mailing Address January 28, 2020

Registered at PO BOX 9, NAMPA, ID 836530009 (Tel: 2084674431)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 28, 2020

Dentist (License #D-5101 in ID)

NPI Profile Active June 14, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 14, 2017

Registered at 2423 W DUNLAP AVE STE 140, PHOENIX, AZ 850215818 (Tel: 6022795351)

📍
Updated Business Mailing Address June 14, 2017

Registered at 5798 SHADY STONE DR, SOUTH JORDAN, UT 840958089 (Tel: (503) 715-7986)

👤
Provider Name / Credentials Updated June 14, 2017

Recorded as NATHANIEL BORK, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 14, 2017

Dentist (License #D008311 in AZ)

NPI Profile Active September 13, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location September 13, 2011

Registered at 980 WILLOW CREEK RD, PRESCOTT, AZ 863011611 (Tel: 9284451682)

📍
Updated Business Mailing Address September 13, 2011

Registered at 5798 SHADY STONE DR, SOUTH JORDAN, UT 840958089 (Tel: 5037157986)

👤
Provider Name / Credentials Updated September 13, 2011

Recorded as NATHANIEL BORK, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2011

Dentist (License #D008311 in AZ)

🟢
Initial NPI Registration & Enumeration September 13, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972885200
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 13, 2011
Last Update: January 28, 2020
Sole Proprietor: No

Mailing Address

Po Box 9

Nampa, ID 836530009

Phone: 2084674431

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.