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

Mongillo Orthodontics, PLLC

Organization Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1043904659

Mongillo Orthodontics, PLLC is an Orthodontics and Dentofacial Orthopedics Dentistry in Idaho Falls, Idaho. Registered with an NPI since 2023.

In the registry since
2023
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

250 S Skyline Dr Ste 4
Idaho Falls, ID 83402-3294
Phone: (208) 524-1404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X

Record details

NPI number1043904659
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anthony Mongillo — Sole Member/Orthodontist · (208) 524-1404
NPI enumeratedJune 6, 2023
Last updated in NPPESMay 9, 2024
Certification dateMay 9, 2024
Mailing address250 S Skyline Dr Ste 4, Idaho Falls, ID 83402-3294

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