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

Willow Creek Dental PC

Organization Dental Clinic/Center · NPI 1780819516

Willow Creek Dental PC is a Dental Clinic/Center in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2009.

Licensed in
ID
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1380 Latah Ave
Idaho Falls, ID 83402
Phone: (208) 552-0919
Fax: (208) 552-1010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence D-4179 (ID)

Record details

NPI number1780819516
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brandon Gordon — Dentist · (208) 552-0919
NPI enumeratedMay 22, 2009
Last updated in NPPESMay 22, 2009
Mailing addressPo Box 50938, Idaho Falls, ID 83405-0938

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