NPI age
19 years
Enumerated 2007-01-08
● Active
Type 1 · Individual
DR. Charles Jared Randall, DDS
Randall is 1 of 3 dentist providers in Ammon and 1 of 135 in Idaho.
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-07-24
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 135 active dentist providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
14% of peers hold multiple states
Subspecialties
0
17% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Practice location
3285 E. 17th St.
Ammon, ID 834066758
Mailing address
3285 E. 17th St.
Ammon, ID 834066758
Specialties
-
Dentist PrimaryThat area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806122100 |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 135 Dentist providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this provider
- 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.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.