NPI age
19 years
Enumerated 2006-07-19
● Active Type 2 · Organization
Idaho Facial Imaging Llc
Idaho Facial Imaging Llc is 1 of 16 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Stauts
Owner/partner
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 16 active clinic/center providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
8119 Ustick Rd, Suite 101
Boise, ID 837045754
Mailing address
8119 Ustick Rd, Suite 101
Boise, ID 837045754
Authorized official
Braden M Stauts, DDS
Owner/partner
📞 2085144740
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Robert Olson, DDS Dentist NPI 1881861581
- Jamison Spencer, D.M.D. Dentist NPI 1285654848
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010156829 | REGENCE BLUE SHIELD-MEDIC |
| 01 (ID) | 000010156827 | REGENCE BLUE SHIELD-DENTA |
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.