DESERT VALLEY DENTISTRY NPI 1083143739

NPI Information

NPI: 1083143739
Provider Name: DESERT VALLEY DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
716 YELLOWSTONE AVE
POCATELLO, ID
ZIP 83201
Phone: (208) 478-1295
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DESERT VALLEY DENTISTRY is a dental clinic center in Pocatello, ID. DESERT VALLEY DENTISTRY NPI is 1083143739. The provider is registered as an organization entity type.

The provider's business location address is:

716 YELLOWSTONE AVE
POCATELLO, ID
ZIP 83201-407
Phone: (208) 478-1295
Fax: (208) 232-5490

The provider's authorized official is Larry Walden Bybee .
The authorized official title is Dentist and has the following contact phone number (208) 478-1295.

The enumeration date for this NPI number is 6/7/2017 and was last updated on 6/7/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	D1664	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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