NPI age
3 years
Enumerated 2022-08-05
● Active Type 2 · Organization
Subpart
Signature Idaho Dental Partners Pc
Signature Idaho Dental Partners Pc is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
4
3 secondary on file
Status
Active
No deactivations on record
Authorized official
Bennion
Director Of Integrations
Last NPPES update
2025-11-05
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
3 years
↓ 5 yr below median
Practice locations
4
3 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-08Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
1500 W Cayuse Creek Dr Ste 100
Meridian, ID 836464757
Mailing address
410 N 44th St Ste 600
Phoenix, AZ 850087616
Additional practice locations
3 secondary locations on file with NPPES.
Location 2
256 Martin St
Twin Falls, ID 833014542
Location 3
2201 N Government Way Ste G
Coeur D Alene, ID 838143658
Location 4
188 River Vista Pl
Twin Falls, ID 833013056
Authorized official
Melody Bennion
Director Of Integrations
📞 4802348490
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Matthew Kooyman, DDS Dentist NPI 1699782854
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (5)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Canyon Gate Cosmetic & Family Dentistry
-
Coeur d'Alene Family Dentistry
-
Linder Road Family & Cosmetic Dentistry
-
Roberts & Hall Dentistry
-
Linder Road Family & Cosmetic Dentistry
Practice context
Multi-provider organization. 1 individual provider on file at this primary address. Plus 3 secondary practice locations.
Subpart of Signature Dental Partners Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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