NPI age
19 years
Enumerated 2007-02-09
● Active
Type 1 · Individual
DR. Randall G. Smith
Smith is 1 of 7 dentist providers in Ammon and 1 of 114 in Idaho.
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-04-08
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 114 active dentist providers in Idaho.
NPI age
19 years
↑ 6 yr above median (13 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
32% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Practice location
2805 Eagle Drive
Ammon, ID 83406
Mailing address
2805 Eagle Drive
Ammon, ID 83406
Specialties
-
Dentist PrimaryAn age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 6C024 | BLUE CROSS OF IDAHO |
| 05 (ID) | 804126800 |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- 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.
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