Whitewater Oral Surgery Group Pllc
Oral and Maxillofacial Dental Clinic
3003 W Main St Ste 130, Boise
Idaho, 83702-2026
208-342-7610 208-344-1799
Maps & DirectionsWhitewater Oral Surgery Group Pllc is a Oral and Maxillofacial Dental Clinic in Boise, Idaho. It is located at 3003 W Main St Ste 130, Boise, ID and its contact number is 208-342-7610. The authorized person for Whitewater Oral Surgery Group Pllc is Dr. Kevin Glenn Kempers
who is Owner of the clinic and their contact number is 208-342-7610. The primary license number for Whitewater Oral Surgery Group Pllc is D3407 (Oral and Maxillofacial Surgery) in Idaho.
Whitewater Oral Surgery Group Pllc Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
Whitewater Oral Surgery Group Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Whitewater Oral Surgery Group Pllc |
| Specialization: | Oral and Maxillofacial Surgery |
| Clinic Address: | 3003 W Main St Ste 130, Boise,
Idaho, 83702-2026 |
| Phone: | 208-342-7610 |
| Fax: | 208-344-1799 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Kevin Glenn Kempers |
| Position: | Owner |
| Contact Number: | 208-342-7610 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Whitewater Oral Surgery Group Pllc clinic are as mentioned below.
| NPI Number: | 1104248053 |
| NPI Enumeration Date: | 13 Jan, 2014 |
| NPI Last Update On: | 04 Sep, 2020 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Whitewater Oral Surgery Group Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral and Maxillofacial Surgery | D3407 | Idaho | Primary | |
| Oral and Maxillofacial Surgery | M7750 | Idaho | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 805496900 | Medicaid | Idaho | |
| 805511300 | Medicaid | Idaho | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Whitewater Oral Surgery Group Pllc
3003 W Main St Ste 130,
Boise, Idaho |
| Zip: | 83702-2026 |
| Phone Number: | 208-342-7610 |
| Fax Number: | 208-344-1799 |
Patients can reach Whitewater Oral Surgery Group Pllc at
3003 W Main St Ste 130, Boise, Idaho or can
call to book an appointment on 208-342-7610.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.