NPI age
10 years
Enumerated 2016-01-12
● Active Type 2 · Organization
Broadway Smiles
Broadway Smiles is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Penuelas
Office Manager
Last NPPES update
2016-01-12
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
10 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2016 → 2026
2016-01Enumerated in NPPES
2016
2026
Where they practice
Primary practice location
505 1st St Ste B
Idaho Falls, ID 834013929
Mailing address
505 1st St Ste B
Idaho Falls, ID 834013929
Authorized official
Nataly Penuelas
Office Manager
📞 2086800186
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Signature Smiles
Practice context
Single-site organization. Only one practice location on file.
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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.