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EYEDAHO OPTOMETRIC LLC
NPI 1417627480
Optometrist in Idaho Falls, ID

Active since September 20, 2021
500 S UTAH AVE, IDAHO FALLS, ID 83402(208) 528-8643 Get Directions Write a Review

NPPES record last updated: September 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eyedaho Optometric Llc NPPES

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

EYEDAHO OPTOMETRIC LLC (NPI 1417627480) is a healthcare organization registered as an optometrist in Idaho Falls, Idaho and active in the NPI registry since September 2021. The organization lists Trevor Dickson, Owner, as its authorized official.

NPPES Registry Identity

NPI1417627480
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameEYEDAHO OPTOMETRIC LLC
Location Address500 S UTAH AVEIdaho Falls, ID 83402-3305
Mailing Address500 S Utah AveIdaho Falls, ID 83402-3305 · (208) 528-8643 · Fax (208) 528-7243
Phone(208) 528-8643
Organization SubpartNo
Authorized OfficialTrevor DicksonOwner · (208) 709-5371
Enumeration DateSeptember 20, 2021
NPPES CertifiedSeptember 2, 2021
✔ NPI 1417627480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
500 S UTAH AVE, Idaho Falls, ID 83402
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Other Identifiers 1

MedicaidIDTPID015646ID

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 11

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

LEILI IZADI
Pharmacist
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 552-6169
DR. GOLDEN THANE SMITH O.D.
Optometrist
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-8643
WALMART INC.
Pharmacy (Community/Retail Pharmacy)
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-8703
EYEDAHO OPTOMETRIC LLC
Clinic/Center
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 709-5371
DR. JENNIFER ANNE GUNTER PHARMD
Pharmacist
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-8703
BRIAN CHRISTENSON
Pharmacist
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-8703
WAL-MART STORES, INC
Eyewear Supplier
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-8735
JOE HOLLAND
Pharmacist
500 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-8703

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 Eyedaho Optometric LLC's NPI number?

The NPI number for Eyedaho Optometric LLC is 1417627480. It was assigned to this organization in the NPPES registry on September 20, 2021.

Where is Eyedaho Optometric LLC located?

Eyedaho Optometric LLC is located at 500 S Utah Ave, Idaho Falls, ID 83402. The listed phone number is (208) 528-8643.

What is Eyedaho Optometric LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Eyedaho Optometric LLC was last updated on September 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.