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

Jerome Toothtown PLLC

Organization Pediatric Dentistry · NPI 1568100857

Jerome Toothtown PLLC is a Pediatric Dentistry in Jerome, Idaho. Registered with an NPI since 2022.

In the registry since
2022
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

1555 S Lincoln Ave
Jerome, ID 83338-6136
Phone: (208) 539-9876
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1568100857
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jesse Ivie — Manager · (208) 539-9876
NPI enumeratedMay 25, 2022
Last updated in NPPESMay 25, 2022
Certification dateMay 25, 2022
Mailing address1555 S Lincoln Ave, Jerome, ID 83338-6136

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