NPI age
8 years
Enumerated 2017-07-03
● Active
Type 1 · Individual
DR. Connor Fairbanks, DDS
Fairbanks is 1 of 69 dentist providers in Pocatello and 1 of 1099 in Idaho.
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2017-07-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1099 active dentist providers in Idaho.
NPI age
8 years
↓ 10 yr below median (18 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
12% of peers hold subspecialties
NPI lifetime · 2017 → 2026
2017-07Enumerated in NPPES
2017
2026
Where they practice
Practice location
921 S 8th Ave Stop 8088
Pocatello, ID 832090002
Mailing address
921 S 8th Ave Stop 8088
Pocatello, ID 832098088
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | D-4836 | IDAHO STATE BOARD OF DENTISTRY (DENTAL LICENSE) |
Practice context
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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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.