FOOTHILLS DENTAL CARE NPI 1275619090

NPI Information

  • NPI: 1275619090
  • Provider Name: FOOTHILLS DENTAL CARE
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 2205 CHANNING WAY
    SUITE A
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 529-4484

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NPI Details

FOOTHILLS DENTAL CARE is a dental clinic center in Idaho Falls, ID. FOOTHILLS DENTAL CARE NPI is 1275619090. The provider is registered as an organization entity type.

The provider's business location address is:

2205 CHANNING WAY
SUITE A
IDAHO FALLS, ID
ZIP 83404-016
Phone: (208) 529-4484
Fax: (208) 523-4441

The provider's authorized official is Wayne Bernell Murdock .
The authorized official title is Owner/partner and has the following contact phone number (208) 529-4484.

The enumeration date for this NPI number is 10/27/2006 and was last updated on 8/22/2020.

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
1261QD0000XClinic/CenterDentalD1719IDAHOYes

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: 11/21/2025

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