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

Willow Tree Dental Group LLC

Organization Periodontics · NPI 1093974446

Willow Tree Dental Group LLC is a Periodontics in Meridian, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

317 W Cherry Ln
Meridian, ID 83642-1608
Phone: (208) 472-7817
Fax: (208) 345-2601
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence D3443 (ID)

Record details

NPI number1093974446
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWillow Tree Dental Group LLC
Authorized official Shannon Love — Financial Manager · (208) 472-7817
NPI enumeratedJune 2, 2008
Last updated in NPPESJune 2, 2008
Mailing address317 W Cherry Ln, Meridian, ID 83642-1608

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