Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clubhouse Pediatric Dentistry of Idaho Falls

Organization Pediatric Dentistry · NPI 1376028324

Clubhouse Pediatric Dentistry of Idaho Falls is a Pediatric Dentistry in Idaho Falls, Idaho. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

3411 Merlin Dr
Idaho Falls, ID 83404-7430
Phone: (208) 520-1514
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1376028324
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Robison — Credentialing Coordinator · (208) 520-1514
NPI enumeratedSeptember 26, 2018
Last updated in NPPESSeptember 26, 2018
Mailing address3411 Merlin Dr, Idaho Falls, ID 83404-7430

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