NPI age
11 years
Enumerated 2014-09-30
● Active Type 2 · Organization
Periodontal Health Specialists Of Idaho
Periodontal Health Specialists Of Idaho is 1 of 37 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Demetter
Owner/partner
Last NPPES update
2023-05-08
Source: monthly bulk 2026-05
How this organization compares
Across 37 active dentist providers in Idaho.
NPI age
11 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-09Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
140 E Boise Ave
Boise, ID 83706
Mailing address
140 E Boise Ave
Boise, ID 83706
Authorized official
Randy S Demetter, DDS, MS
Owner/partner
📞 2083859228
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Randy Demetter, DDS Dentist NPI 1275941288
- Jack Lincks, DDS, MS Dentist NPI 1346224458
- Stephen Morris, D.D.S. M.S. Dentist NPI 1386859098
- John Mumford, D.M.D. Dentist NPI 1639149057
- Keaton Nicholson Student in an Organized Health Care Education/Training Program NPI 1902749864
Specialties
-
Dentist PrimaryThat specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Florence and Lincks and Associates
Practice context
Multi-provider organization. 5 individual providers 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 →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.