NPI age
19 years
Enumerated 2007-03-16
● Active Type 2 · Organization
Madison Park Dental Center Pllc
Madison Park Dental Center Pllc is 1 of 591 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Walker
President
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 591 active dentist providers in Idaho.
NPI age
19 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
35 Madison Professional Park
Rexburg, ID 83440
Mailing address
35 Madison Professional Park
Rexburg, ID 83440
Authorized official
Robert L Walker
President
📞 2083565601
Individual providers at this organization
2 individual providers on file at this primary practice address.
- James Allen, D.D.S. Dentist NPI 1356352090
- Robert Walker, D.M.D. Dentist NPI 1548271273
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 6I120 | BLUE CROSS |
| 05 (ID) | 80659700 | |
| 01 (ID) | 6I138 | BLUE CROSS |
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.