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

Idaho Falls Pediatric Dentistry, PLLC

Organization Pediatric Dentistry · NPI 1700447596

Idaho Falls Pediatric Dentistry, PLLC is a Pediatric Dentistry in Ammon, Idaho. 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

3015 Eagle Dr
Ammon, ID 83406-1273
Phone: (208) 419-3622
Fax: (208) 419-3461
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 number1700447596
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kailey Housley — Pediatric Dentist, Owner · (208) 419-3622
NPI enumeratedJune 24, 2019
Last updated in NPPESMay 28, 2025
Certification dateMay 28, 2025
Mailing address3387 Merlin Dr, Idaho Falls, ID 83404-7405

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