TETON VALLEY DENTAL CENTER PLLC (NPI# 1063783868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063783868 |
| Entity Type | Organization |
| Organization Name | TETON VALLEY DENTAL CENTER PLLC |
| Practice Address |
235 E. Wallace Ave. Driggs ID 83442 |
| Mailing Address |
Po Box 791 235 E., Wallace Ave. Driggs ID 83422-0791 |
| Practice Telephone | 2083548181 |
| Practice Fax Number | 2083548182 |
| Mailing Telephone | 2083548181 |
| Mailing Fax Number | 2083548182 |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-01-25 |
| Authorized Official Name | JAMES C ALLEN (PRESIDENT) |
| Authorized Official Telephone | 2083548181 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
D1657 | ID | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D3634 | ID | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801112628 | Teton Valley Dental Center Pllc | Clinic/Center | 235 E. Wallace Ave., Driggs, ID 83422-0791 | 2010-04-19 |
| Street Address |
235 E. WALLACE AVE. |
| City | DRIGGS |
| State | ID |
| Zip Code | 83442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801112628 | Teton Valley Dental Center Pllc | Clinic/Center | 235 E. Wallace Ave., Driggs, ID 83422-0791 | 2010-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657010 | Rigby Pediatric Dental Pllc | Dentist | 688 Rigby Lake Circle, Suite 4, Rigby, ID 83442 | 2020-04-03 |
| 1508400912 | Ranbow LLC | Assisted Living Facility | 130 Stockham Blvd., Rigby, ID 83442 | 2019-10-30 |
| 1740833466 | Lindsay Winger | Speech-Language Pathologist | 152 E Maint St., #110, Rigby, ID 83442 | 2019-07-22 |
| 1457856429 | Kayla Childers | Speech-Language Pathologist | 152 E. Main Street, Rigby, ID 83442 | 2018-03-29 |
| 1174997878 | Zion's Management LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 470 Rigby Lake Dr., Rigby, ID 83442 | 2015-11-18 |
| 1821466376 | Chad Judy | Speech-Language Pathologist | 152 E Main Street, Suite 110, Rigby, ID 83442 | 2015-09-14 |
| 1740588276 | Jessica Brodie | Speech-Language Pathologist | 165 Front Street, Driggs, ID 83442 | 2011-03-08 |
| 1255636304 | Kathy Lebaron | Midwife | 297n 3855 East, Rigby, ID 83442 | 2011-01-21 |
| 1780834077 | Agape Birth Service and Birth Center | Midwife | 297 N 3855 East, Rigby, ID 83442 | 2008-09-24 |
| 1548431588 | Valley Orthodontics | Dentist | 197 Stockham Blvd, Suite A, Rigby, ID 83442 | 2008-03-18 |
| Find all providers in zip 83442 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801112628 | Teton Valley Dental Center Pllc | Clinic/Center | 235 E. Wallace Ave., Driggs, ID 83422-0791 | 2010-04-19 |
| 1073776050 | Cottonwood Dental Care, Pa | Clinic/Center | 180 S Main St, Suite B2, Driggs, ID 83422-5034 | 2008-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864384 | Kuna Kids Dentistry PC | Clinic/Center | 1385 N Jacksonmill Ave, Kuna, ID 83634-2042 | 2020-09-08 |
| 1720691785 | Advanced Dentistry of Mccall | Clinic/Center | 313 Deinhard Ln, Mccall, ID 83638-4703 | 2020-08-28 |
| 1720698608 | Club 32 Dental | Clinic/Center | 624 3rd St S, Nampa, ID 83651-3840 | 2020-08-05 |
| 1831732502 | Hughes Dental Pllc | Clinic/Center | 834 Falls Ave Ste 2030, Twin Falls, ID 83301-3365 | 2019-10-24 |
| 1083279087 | Idaho Buckeye Inc | Clinic/Center | 1537 2nd Ave S, Payette, ID 83661-2919 | 2019-05-06 |
| 1639637168 | Scott Carter, Inc | Clinic/Center | 982 Banks Lowman Rd, Garden Valley, ID 83622 | 2019-03-04 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1831678903 | Town Square Dental Partners, Pllc | Clinic/Center | 8660 W Emerald St Ste 152, Boise, ID 83704-4828 | 2018-08-09 |
| 1265935902 | Wilson Dental Pllc | Clinic/Center | 10497 W Garverdale Ct Ste 107, Boise, ID 83704-5468 | 2018-03-08 |
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| 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.