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

Dr. Jacob Vaughn Liljenquist, DMD

Individual provider General Practice Dentistry · NPI 1508172107

Dr. Jacob Vaughn Liljenquist, DMD is a General Practice Dentistry in Pocatello, Idaho. Licensed in Idaho, Utah and Washington. Registered with an NPI since 2010.

Licensed in
ID, UT, WA
In the registry since
2010
Specialties on file
4
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1000 N 8th Ave
Pocatello, ID 83201-5757
Phone: (208) 232-3368
Fax: (208) 776-5016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 7754866-9921 (UT)
Dentist Taxonomy 122300000X · Licence 7754866-9921 (UT)
Dentist Taxonomy 122300000X · Licence DE60162914 (WA)
Public Health Dentistry Taxonomy 1223D0001X · Licence D4811 (ID)

Record details

NPI number1508172107
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedAugust 20, 2010
Last updated in NPPESMay 17, 2019

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