FOOTHILLS DENTAL CARE, PLLC (NPI# 1205175668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205175668 |
| Entity Type | Organization |
| Organization Name | FOOTHILLS DENTAL CARE, PLLC |
| Other Organization Name | RIVERWEST DENTAL |
| Practice Address |
1655 Pancheri Dr Idaho Falls ID 83402-3169 |
| Mailing Address |
2205 Channing Way Suite A Idaho Falls ID 83404-8016 |
| Practice Telephone | 2085221911 |
| Practice Fax Number | 2085234441 |
| Mailing Telephone | 2085294484 |
| Mailing Fax Number | 2085234441 |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-06 |
| Authorized Official Name | MRS. MELISSA K RAICHART (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 2085294484 |
| Is Organization Subpart | Y |
| Parent Organization Name | FOOTHILLS DENTAL CARE, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D3464 | ID | Dental Providers |
| N | 122300000X | Dentist | D4302 | ID | Dental Providers |
| N | 122300000X | Dentist | D1719 | ID | Dental Providers |
| Y | 122300000X | Dentist | D3971 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1275619090 | 05 | |
| ID | 1952317703 | 05 | |
| ID | 1134356140 | 05 | |
| ID | 1609952415 | 05 | |
| ID | 1740501410 | 05 | |
| ID | 1124035498 | 05 |
| Other Name | Type Code |
|---|---|
| RiverWest Dental | Doing Business As Name - Organization |
| Street Address |
1655 PANCHERI DR |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033560578 | Id Dental Associates, P.C. | Dentist | 2818 S 25th E, Idaho Falls, ID 83404 | 2016-06-27 |
| 1386953958 | Chad Jeffrey Coombs | Dentist | 2860 Valencia Dr Ste 100, Idaho Falls, ID 83404-7597 | 2010-09-30 |
| 1790092468 | Jeff Ybarguen | Dentist | 3423 Merlin Dr Ste 100, Idaho Falls, ID 83404-7430 | 2010-09-01 |
| 1376876110 | Kent Cutforth Dds | Dentist | 1370 E. 17th Street, Idaho Falls, ID 83404 | 2009-09-11 |
| 1992968804 | Brandon D Gordon | Dentist | 7186 Sage View Cr, Idaho Falls, ID 83406 | 2008-07-10 |
| 1083818371 | Philip R Harper | Dentist | 3550 Washington Pkwy, Idaho Falls, ID 83404-4968 | 2007-06-12 |
| 1356465660 | Eagle Rock Dental Care | Dentist | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2007-03-19 |
| 1750413456 | Thomas T Anderson | Dentist | 2685 Channing Way, Idaho Falls, ID 83404 | 2007-03-09 |
| 1619010477 | Vern Barry Bruggeman | Dentist | 333 So Woodruff Ave, Idaho Falls, ID 83401 | 2007-02-14 |
| 1851449003 | Elite Dental Care, Pllc | Dentist | 3423 Merlin Dr, Suite 100, Idaho Falls, ID 83404-7430 | 2007-01-06 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on FOOTHILLS DENTAL CARE, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.