NPI age
18 years
Enumerated 2008-04-22
● Active Type 2 · Organization
Alligator Pediatric Dentistry ,pllc
Alligator Pediatric Dentistry ,pllc is 1 of 114 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Smith
Owner
Last NPPES update
2024-04-08
Source: monthly bulk 2026-05
How this organization compares
Across 114 active dentist providers in Idaho.
NPI age
18 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-04Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
2805 Eagle Drive
Ammon, ID 83406
Mailing address
2805 Eagle Drive
Ammon, ID 83406
Authorized official
Randy G. Smith, D.D.S
Owner
📞 2085421333
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Randall Smith Dentist NPI 1659412724
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 |
|---|---|---|
| 05 (ID) | 8041268000 |
Practice context
Multi-provider organization. 1 individual provider 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 →
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