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Contact Information

IDAHO FALLS DENTAL GROUP
2300 E 17TH ST
IDAHO FALLS, ID83404-6504
 Phone: 208-525-8383
 Fax: 208-523-6419
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for IDAHO FALLS DENTAL GROUP

NPI # 1497803696
LBN Legal business name IDAHO FALLS DENTAL GROUP
Authorized official TRACY LARSEN - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/07/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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