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POCATELLO FAMILY DENTISTRY
NPI 1851516256
Dentist - General Practice in Pocatello, ID

Active since April 13, 2007
465 MEMORIAL DR., POCATELLO, ID 83209(208) 282-6000(208) 282-4950 Get Directions Write a Review

NPPES record last updated: March 24, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pocatello Family Dentistry NPPES

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

POCATELLO FAMILY DENTISTRY (NPI 1851516256) is a healthcare organization registered as a general practice in Pocatello, Idaho and active in the NPI registry since April 2007. The organization lists Brian Robert Crawford, Program Director Iagd, as its authorized official.

NPPES Registry Identity

NPI1851516256
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameIDAHO STATE UNIVERSITY
Location Address465 MEMORIAL DR.Pocatello, ID 83209-8088
Mailing Address921 S. 8th Ave., Stop 8088Pocatello, ID 83209-8088 · (208) 282-6000 · Fax (208) 282-4950
Phone(208) 282-6000
Fax(208) 282-4950
Organization SubpartYes
Authorized OfficialBrian Robert CrawfordProgram Director Iagd · (208) 282-5275
Enumeration DateApril 13, 2007
Last NPPES UpdateMarch 24, 2008
✔ NPI 1851516256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A 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.
465 MEMORIAL DR., Pocatello, ID 83209
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Other Names 1

Doing Business AsPocatello Family Dentistry

Other Identifiers 2

Medicaid181764ID
Medicaid8057101ID

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 2

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

DR. JESSICA BETH HETCKO DDS
Dentist (General Practice)
465 MEMORIAL DR., POCATELLO FAMILY DENTISTRY ISU
POCATELLO, ID 83209
Bannock County (208) 282-6000
DR. BRIAN ROBERT CRAWFORD DDS
Dentist (General Practice)
465 MEMORIAL DR.
POCATELLO, ID 83209
Bannock County (208) 282-5275

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 Idaho State University's NPI number?

The NPI number for Idaho State University is 1851516256. It was assigned to this organization in the NPPES registry on April 13, 2007. The provider is doing business as Pocatello Family Dentistry.

Where is Idaho State University located?

Idaho State University is located at 465 Memorial Dr., Pocatello, ID 83209. The listed phone number is (208) 282-6000.

What is Idaho State University's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Idaho State University was last updated on March 24, 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.