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

Eagle Dental Partnership PLLC

Organization General Practice Dentistry · NPI 1639732399

Eagle Dental Partnership PLLC is a General Practice Dentistry in Eagle, Idaho. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

577 E State St
Eagle, ID 83616-5938
Phone: (208) 939-3500
Fax: (208) 939-3837
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 450 W State St Ste 115, Eagle, ID 83616-7055 — (208) 342-4644

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1639732399
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leah Gardoski — Insurance Administrator · (208) 939-3500
Other names Ascend Dental
NPI enumeratedApril 18, 2019
Last updated in NPPESAugust 11, 2025
Mailing address577 E State St, Eagle, ID 83616-5938

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