Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Whitewater Oral Surgery Group PLLC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1104248053

Whitewater Oral Surgery Group PLLC is an Oral and Maxillofacial Surgery (Dentist) in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2014.

Licensed in
ID
In the registry since
2014
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3003 W Main St Ste 130
Boise, ID 83702-2026
Phone: (208) 342-7610
Fax: (208) 344-1799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence D3407 (ID)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence M7750 (ID)

Record details

NPI number1104248053
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Kempers — Owner · (208) 342-7610
NPI enumeratedJanuary 13, 2014
Last updated in NPPESSeptember 4, 2020
Certification dateSeptember 4, 2020
Mailing address3003 W Main St Ste 130, Boise, ID 83702-2026

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