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

Id Dental Associates, PC

Organization Dentist · NPI 1033560578

Id Dental Associates, PC is a Dentist in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2016.

Licensed in
ID
In the registry since
2016
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2818 S 25th E
Idaho Falls, ID 83404
Phone: (208) 243-8391
Fax: (208) 243-8391
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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-4206 (ID)

Record details

NPI number1033560578
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Bertollini — Prs · (866) 273-8204
NPI enumeratedJune 27, 2016
Last updated in NPPESJune 27, 2016
Mailing addressPo Box 3189, Syracuse, NY 13220-3189

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