NPI age
19 years
Enumerated 2007-02-21
● Active
Type 1 · Individual
DR. Robert L Fackrell, DDS
Fackrell is 1 of 69 dentist providers in Pocatello and 1 of 1099 in Idaho.
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-01-13
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1099 active dentist providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
12% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Practice location
415 N 3rd Ave Ste A
Pocatello, ID 832016306
Mailing address
415 N 3rd Ave Ste A
Pocatello, ID 832016306
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 537818 | UNITED CONCORDIA |
| 01 (ID) | 000010010434 | BLUE CROSS |
| 05 (ID) | 002783500 |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.