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

Retina Specialists of Idaho, PLLC

Organization Ophthalmology Physician · NPI 1366607996

Retina Specialists of Idaho, PLLC is an Ophthalmology Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008
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

13923 W Wainwright Dr Ste 301
Boise, ID 83713-1969
Phone: (208) 938-5624
Fax: (208) 938-5764
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence M-10066 (ID)

Record details

NPI number1366607996
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Denton Roberts — Owner · (208) 938-5624
NPI enumeratedJuly 23, 2008
Last updated in NPPESApril 10, 2012
Mailing address13923 W Wainwright Dr, Suite 301, Boise, ID 83713-1969

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