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

Family Dental of Blackfoot LLC

Organization Dentist · NPI 1205208162

Family Dental of Blackfoot LLC provides Dentist services in Blackfoot, Idaho. Licensed in Idaho. Registered with an NPI since 2015.

Licensed in
ID
In the registry since
2015
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2407 Teeples Dr
Blackfoot, ID 83221-5877 Not confirmed with CMS for 10 years — call before visiting
Phone: (208) 782-0242
Fax: (208) 782-1160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D-3614 (ID)
Dentist Taxonomy 122300000X · Licence D-3830 (ID)

Record details

NPI number1205208162
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bryce Burtenshaw — Owner · (208) 782-0242
NPI enumeratedOctober 30, 2015
Last updated in NPPESOctober 30, 2015
Mailing address2407 Teeples Dr, Blackfoot, ID 83221-5877

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