NPI age
19 years
Enumerated 2006-10-02
● Active
Type 1 · Individual
Matthew G. Fethke, D.D.S.
Fethke is 1 of 214 dentist providers in Boise and 1 of 1099 in Idaho.
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
2006-10Enumerated in NPPES
2006
2026
Where they practice
Practice location
12212 W Amity Rd
Boise, ID 837095389
Mailing address
12212 W Amity Rd
Boise, ID 837095389
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) | 6O662 | BLUE CROSS OF IDAHO |
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
Recently enumerated nearby: 3 new dentist providers have been added in Boise in the last 180 days.
See all →
Provyx · Custom healthcare lists
Need all 1099 Dentist providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this provider
- 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.