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RIDGE CREST PERIODONTICS
NPI 1104085935
Clinic/Center - Dental in Idaho Falls, ID

Active since June 06, 2008
2375 E SUNNYSIDE RD, SUITE I, IDAHO FALLS, ID 83404(208) 522-6683(208) 552-3085 Get Directions Write a Review

NPPES record last updated: June 6, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ridge Crest Periodontics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIDGE CREST PERIODONTICS (NPI 1104085935) is a healthcare organization registered as a dental in Idaho Falls, Idaho and active in the NPI registry since June 2008. The organization lists Ethan D Moulton, Owner, as its authorized official.

NPPES Registry Identity

NPI1104085935
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMOULTON PERIODONTICS, PLLC
Location Address2375 E SUNNYSIDE RD, SUITE IIdaho Falls, ID 83404-8280
Mailing Address2375 E Sunnyside Rd, Suite IIdaho Falls, ID 83404-8280 · (208) 522-6683 · Fax (208) 552-3085
Phone(208) 522-6683
Fax(208) 552-3085
Organization SubpartNo
Authorized OfficialEthan D MoultonOwner · (208) 522-6683
Enumeration DateJune 6, 2008
✔ NPI 1104085935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in ID · D-4093-PE
2375 E SUNNYSIDE RD, Idaho Falls, ID 83404
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Other Names 1

Doing Business AsRidge Crest Periodontics

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAIN SPECIALISTS OF IDAHO
Clinic/Center (Pain)
2375 E SUNNYSIDE RD, SUITE 'J'
IDAHO FALLS, ID 83404
Bonneville County (208) 522-7246
MAGGI BRADLEY
Pharmacist
2375 E SUNNYSIDE RD
IDAHO FALLS, ID 83404
Bonneville County (208) 623-8614
MR. RUSSELL HENRY PETERSON M.S.
Counselor (Mental Health)
2375 E SUNNYSIDE RD, SUITE C
IDAHO FALLS, ID 83404
Bonneville County (208) 529-5777
MS. CATHY S KOTTER LPC
Counselor (Mental Health)
2375 E SUNNYSIDE RD, SUITE C
IDAHO FALLS, ID 83404
Bonneville County (208) 529-5777
CATHERINE L. LINDERMAN MD PLLC
Clinic/Center (Pain)
2375 E SUNNYSIDE RD, SUITE A
IDAHO FALLS, ID 83404
Bonneville County (208) 524-0610
CREEKSIDE SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
2375 E SUNNYSIDE RD, SUITE B
IDAHO FALLS, ID 83404
Bonneville County (208) 524-0610
DR. JAMES KENDALL CHRISTENSEN D.O.
Family Medicine (Sports Medicine)
2375 E SUNNYSIDE RD, STE F
IDAHO FALLS, ID 83404
Bonneville County (208) 523-5343
CATHERINE L LINDERMAN MD
Clinic/Center (Pain)
2375 E SUNNYSIDE RD
IDAHO FALLS, ID 83404
Bonneville County (208) 524-0610

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moulton Periodontics, PLLC's NPI number?

The NPI number for Moulton Periodontics, PLLC is 1104085935. It was assigned to this organization in the NPPES registry on June 6, 2008. The provider is doing business as Ridge Crest Periodontics.

Where is Moulton Periodontics, PLLC located?

Moulton Periodontics, PLLC is located at 2375 E Sunnyside Rd Suite I, Idaho Falls, ID 83404. The listed phone number is (208) 522-6683.

What is Moulton Periodontics, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Moulton Periodontics, PLLC was last updated on June 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.