Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114967098 Individual Practitioner Male Practitioner

Dr. Kenneth Charles Prince , DDS

Dentist - General Practice • Council, ID

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Prince, DDS is a registered healthcare professional specializing in Dentist - General Practice in Council, ID. Practice services are available at 205 N BERKLEY AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

205 N Berkley Ave

Council, ID 83612

Telephone 2082534242
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Council, ID

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

Practicing in Council, 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License ID D4335

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID United Concordia
527932
Commercial Insurance / Payer ID Regence Blue Shield
PR1900

Practice Associates & Co-Workers

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

13 Associated Practitioners
Susan Adams , LPN, NDPP COACH

Licensed Practical Nurse

NPI 1124710819

Licensed Practical Nurse, NDPPCOACH

Alex Wright , PA

Physician Assistant

NPI 1164140786

Physician Assistant

NPI 1326197278

Doctor of Osteopathic Medicine (D.O.)

Andria Hall , MA

Health Educator

NPI 1386131019

Master of Arts

Amy Beam , FNP

Nurse Practitioner - Primary Care

NPI 1528550860

Family Nurse Practitioner

Chelsy Taylor , PA-C

Physician Assistant

NPI 1578994356

Physician Assistant (Certified)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active September 13, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 13, 2012

Registered at 205 N BERKLEY AVE, COUNCIL, ID 83612 (Tel: 2082534242)

📍
Updated Business Mailing Address September 13, 2012

Registered at PO BOX 428, COUNCIL, ID 836120428 (Tel: 2082534242)

👤
Provider Name / Credentials Updated September 13, 2012

Recorded as KENNETH PRINCE, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2012

Dentist (License #D4335 in ID)

🟢
Initial NPI Registration & Enumeration June 07, 2006

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: 1114967098
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2006
Last Update: September 13, 2012
Sole Proprietor: No

Mailing Address

Po Box 428

Council, ID 836120428

Phone: 2082534242

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.