Organization
Idaho Dental Anesthesia PLLC
Provider's NPPES record last updated: August 12, 2020
Overview
- Entity Type
- Organization
- NPI
- 1629470141
- Primary Specialty
- Dentist — Dental Anesthesiology
- Practice Location
- Meridian, Idaho
- Organization Subpart
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 20, 2026, 11:57 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Dentist
Dental Anesthesiology
Dental Providers
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
Taxonomy code 1223D0004X
Provider-Reported License Information
- Dentist (Idaho)
- D-4613
Practice Locations
Practice Location
37 W Archerfield St Ste 100
Meridian, Idaho 83646-6587
Phone: (208) 391-2894
Additional Practice Location
1550 E Heritage Park St
Meridian, Idaho 83646-6439
Phone: (503) 679-9797
Additional Practice Location
317 S River St
Hailey, Idaho 83333-8426
Phone: (503) 679-9797
Additional Practice Location
1411 Falls Ave E Ste 1000c
Twin Falls, Idaho 83301-3459
Phone: (503) 679-9797
Additional Practice Location
1408 Pomerelle Ave Ste D
Burley, Idaho 83318-2068
Phone: (503) 679-9797
Additional Practice Location
12190 W Evely Pines Ln
Star, Idaho 83669-6126
Phone: (503) 679-9797
Additional Practice Location
478 Sw 12th St
Ontario, Oregon 97914-3202
Phone: (503) 679-9797
Additional Practice Location
136 E Mallard Dr
Boise, Idaho 83706-3975
Phone: (503) 679-9797
Additional Practice Location
1186 Eastland Dr N
Twin Falls, Idaho 83301-8973
Phone: (503) 679-9797
Additional Practice Location
1311 E Central Dr
Meridian, Idaho 83642-7991
Phone: (503) 679-9797
Additional Practice Location
1619 N Whitley Dr
Fruitland, Idaho 83619-2162
Phone: (503) 679-9797
Record Information
- Enumeration Date
- September 17, 2014
- Provider's NPPES Record Last Updated
- August 12, 2020
- Certification Date
- August 12, 2020
- NPISignal NPPES Dataset
- August 2026
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