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

Idaho State University

Organization Dentist · NPI 1912110164

Idaho State University is a Dentist in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007

Practice location Address checks out

2033 E Summersweet Dr
Boise, ID 83716-6695
Phone: (208) 331-0182
Fax: (208) 331-0184
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D-1819 (ID)

Record details

NPI number1912110164
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tina Freeman — Office Manager · (208) 331-0182
NPI enumeratedMay 7, 2007
Last updated in NPPESJune 24, 2008
Mailing address2033 E Summersweet Dr, Boise, ID 83716-6695

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