NPI age
12 years
Enumerated 2013-11-06
● Active Type 2 · Organization
Robert L. Fackrell DDS PA
Robert L. Fackrell DDS PA is 1 of 591 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Fackrell
President
Last NPPES update
2015-01-13
Source: monthly bulk 2026-05
How this organization compares
Across 591 active dentist providers in Idaho.
NPI age
12 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2013 → 2026
2013-11Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
415 N 3rd Ave Ste A
Pocatello, ID 832016306
Mailing address
415 N 3rd Ave Ste A
Pocatello, ID 832016306
Authorized official
Robert L Fackrell, DDS
President
📞 2082332355
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Robert Fackrell, DDS Dentist NPI 1215072798
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1215072798 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Fackrell Family Dentistry
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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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.