NPI age
— years
Enumerated 2025-12-08
● Active Type 2 · Organization
Subpart
Idaho Dental Professionals, P.c.
Idaho Dental Professionals, P.c. is 1 of 1099 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McDougal
Credentialing Coordinator
Last NPPES update
2025-12-08
Source: monthly bulk 2026-05
How this organization compares
Across 1099 active dentist providers in Idaho.
NPI age
0 years
↓ 18 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2025 → 2026
2025-12Enumerated in NPPES
2025
2026
Where they practice
Primary practice location
2003 E Quail Run Rd
Emmett, ID 836175059
Mailing address
2003 E Quail Run Rd
Emmett, ID 836175059
Authorized official
Cemyira McDougal
Credentialing Coordinator
📞 2177648609
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Darren Wallace, D.M.D. Dentist NPI 1841305646
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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Quail Run Dental Care
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Idaho Dental Professionals, P.c..
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.