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

Family Dental of Blackfoot LLC

Organization Dentist · NPI 1205208162

Family Dental of Blackfoot LLC is a Dentist in Blackfoot, Idaho. Licensed in Idaho. Registered with an NPI since 2015.

Licensed in
ID
In the registry since
2015
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2407 Teeples Dr
Blackfoot, ID 83221-5877
Phone: (208) 782-0242
Fax: (208) 782-1160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D-3614 (ID)
Dentist Taxonomy 122300000X · Licence D-3830 (ID)

Record details

NPI number1205208162
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bryce Burtenshaw — Owner · (208) 782-0242
NPI enumeratedOctober 30, 2015
Last updated in NPPESOctober 30, 2015
Mailing address2407 Teeples Dr, Blackfoot, ID 83221-5877

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