P Praxis·MD
● Active Type 1 · Individual

DR. Michael Wynn Godfrey, DMD

Dentist·Pocatello, ID· NPI 1275605933 · Enumerated 2006 · 19 years on NPI
Godfrey is 1 of 69 dentist providers in Pocatello and 1 of 1099 in Idaho.
NPI age
19 years
Enumerated 2006-11-15
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

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 · 2006 → 2026

2006-11Enumerated in NPPES
2006 2026

Where they practice

Practice location
1980 Birdie Thompson Dr
Pocatello, ID 832012755
📞 2082338750fax 2082338751
Mailing address
1980 Birdie Thompson Dr
Pocatello, ID 832012755
📞 2082338750fax 2082338751

Specialties

  • Dentist Primary
    A 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.
    ID license #D-3901 taxonomy 1223G0001X

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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