NPI age
7 years
Enumerated 2018-09-18
● Active Type 2 · Organization
Ikdo State Street Llc
Ikdo State Street Llc is 1 of 135 dentist organizations in Idaho.
Primary specialty
Dentist
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Birch
Office Manager
Last NPPES update
2018-09-18
Source: monthly bulk 2026-05
How this organization compares
Across 135 active dentist providers in Idaho.
NPI age
7 years
↓ 11 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 17% of peers with subspecialties
NPI lifetime · 2018 → 2026
2018-09Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
9209 W State St
Garden City, ID 83714
Mailing address
9209 W State St
Garden City, ID 83714
Authorized official
Jaycie Birch
Office Manager
📞 2083881111
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...
-
DentistAn 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.
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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