Individual provider Active NPI

Scott Pickett, D.D.S.

  • General Practice Dentistry
  • Ammon, ID
National Provider Identifier
1003222506
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D4669-PD Issued in ID
Practice address
2805 Eagle Dr
Ammon, ID 83406-5769
Phone
(208) 542-1333
Fax
(208) 467-5100
NPI assigned
Jul 3, 2014
Last updated
Aug 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D4669-PD ID Primary

Addresses

Primary practice location

2805 Eagle Dr
Ammon, ID 83406-5769

Mailing address

2805 Eagle Dr
Ammon, ID 83406-5769
Phone (208) 542-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D4669-PDIDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Dentistry of Idaho, PLLC Pediatric Dentistry CurrentSince Nov 21, 2021 Accepting new patients
Childrens Dentistry Pediatric Dentistry Current Accepting new patients
Alligator Pediatric Dentistry ,PLLC Pediatric Dentistry PastSince Apr 14, 2024 Accepting new patients
Children's Dentistry PLLC Pediatric Dentistry PastSince Nov 21, 2021 Accepting new patients
Alligator Orthodontics, LLC Pediatric Dentistry PastSince May 12, 2024 Accepting new patients

Locations

349 W Iowa Ave
Nampa, ID 83686
Phone (208) 467-5100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787961600000",
    "number": "1003222506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065769",
            "telephone_number": "208-542-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065769",
            "telephone_number": "208-542-1333",
            "fax_number": "208-467-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "SCOTT",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4669-PD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.