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

Jake Groberg

Individual provider General Practice Dentistry · NPI 1700728391

Jake Groberg is a General Practice Dentistry in Pocatello, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2026

Practice location Address checks out

465 Memorial Dr
Pocatello, ID 83201-4008
Phone: (208) 282-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 3581210 (ID)

Record details

NPI number1700728391
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorYes
NPI enumeratedApril 6, 2026
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026
Mailing address465 Memorial Dr, Pocatello, ID 83201-4008

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