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WILLOW CREEK DENTAL PC
NPI 1780819516
Clinic/Center - Dental in Idaho Falls, ID

Active since May 22, 2009
1380 LATAH AVE, IDAHO FALLS, ID 83402(208) 552-0919(208) 552-1010 Get Directions Write a Review

NPPES record last updated: May 22, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Willow Creek Dental Pc NPPES

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

WILLOW CREEK DENTAL PC (NPI 1780819516) is a healthcare organization registered as a dental in Idaho Falls, Idaho and active in the NPI registry since May 2009. The organization lists Brandon D Gordon, Dentist, as its authorized official.

NPPES Registry Identity

NPI1780819516
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameWILLOW CREEK DENTAL PC
Location Address1380 LATAH AVEIdaho Falls, ID 83402
Mailing AddressPo Box 50938Idaho Falls, ID 83405-0938 · (208) 552-0919 · Fax (208) 552-1010
Phone(208) 552-0919
Fax(208) 552-1010
Organization SubpartNo
Authorized OfficialBrandon D GordonDentist · (208) 552-0919
Enumeration DateMay 22, 2009
✔ NPI 1780819516 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-4179
1380 LATAH AVE, Idaho Falls, ID 83402
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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 Willow Creek Dental PC's NPI number?

The NPI number for Willow Creek Dental PC is 1780819516. It was assigned to this organization in the NPPES registry on May 22, 2009.

Where is Willow Creek Dental PC located?

Willow Creek Dental PC is located at 1380 Latah Ave, Idaho Falls, ID 83402. The listed phone number is (208) 552-0919.

What is Willow Creek Dental PC'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 Willow Creek Dental PC was last updated on May 22, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.