NPI age
6 years
Enumerated 2019-11-05
● Active Type 2 · Organization
Portneuf Valley Dental
Portneuf Valley Dental is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bird
Ceo/owner
Last NPPES update
2019-11-05
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
6 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2019 → 2026
2019-11Enumerated in NPPES
2019
2026
Where they practice
Primary practice location
1246 Yellowstone Ave
Pocatello, ID 832014374
Mailing address
1246 Yellowstone Ave
Pocatello, ID 832014374
Authorized official
Jayson Anders Bird, DDS
Ceo/owner
📞 2086805144
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Alina Bonci Counselor NPI 1265820773
- Wallace Christensen, OD Optometrist NPI 1760435143
- Colin Mahoney, SE Psychologist NPI 1255715330
- Jason Mauseth, DDS Dentist NPI 1316968241
- Michael McHugh, DDS Dentist NPI 1326356122
- Diane Moll Counselor NPI 1467675587
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 6 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.