NPI age
15 years
Enumerated 2010-06-17
● Active
Type 1 · Individual
Kelly Weaver, DDS
Weaver is 1 of 8 dentist providers in Blackfoot and 1 of 591 in Idaho.
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-03-08
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 591 active dentist providers in Idaho.
NPI age
15 years
≈ at median (16 yr)
State licenses
1 state
11% of peers hold multiple states
Subspecialties
0
17% of peers hold subspecialties
NPI lifetime · 2010 → 2026
2010-06Enumerated in NPPES
2010
2026
Where they practice
Practice location
310 W Idaho St
Blackfoot, ID 832211710
Mailing address
Po Box 248
Blackfoot, ID 832210248
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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