Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Clubhouse Pediatric Dentistry of Idaho Falls

Organization Pediatric Dentistry · NPI 1376028324

Clubhouse Pediatric Dentistry of Idaho Falls provides Pediatric Dentistry in Idaho Falls, Idaho. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

3411 Merlin Dr
Idaho Falls, ID 83404-7430
Phone: (208) 520-1514
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1376028324
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Robison — Credentialing Coordinator · (208) 520-1514
NPI enumeratedSeptember 26, 2018
Last updated in NPPESSeptember 26, 2018
Mailing address3411 Merlin Dr, Idaho Falls, ID 83404-7430

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