NPI age
1 years
Enumerated 2024-07-18
● Active Type 2 · Organization
Subpart
Idaho Dental Professionals, P.c.
Idaho Dental Professionals, P.c. is 1 of 1099 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McDougal
Credentialing Coordinator
Last NPPES update
2024-07-18
Source: monthly bulk 2026-05
How this organization compares
Across 1099 active dentist providers in Idaho.
NPI age
1 years
↓ 17 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-07Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
4701 S Eagle Rd. Ste. 100
Meridian, ID 836427563
Mailing address
4701 S Eagle Rd. Ste. 100
Meridian, ID 836427563
Authorized official
Cemyira McDougal
Credentialing Coordinator
📞 2177648609
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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
South Corner Dental Care
Practice context
Single-site organization. Only one practice location on file.
Subpart of Idaho Dental Professionals, P.c..
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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