Kootenai Family Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KOOTENAI FAMILY DENTAL PLLC

Practice address

1420 Lincoln Way Ste 200
Coeur D Alene, ID 83814-2360

Phone

(208) 664-8283

Fax

(208) 667-0794

NPI assigned

Jul 8, 2026

Last updated

Jul 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alexis Larose, DDSNPI 1265728646

Title

Owner/Dentist

Phone

(208) 664-8283

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexis Christine Larose, DDS

  • General Practice Dentistry
  • Coeur d'Alene, ID
  • NPI 1265728646
  Authorized official Same address or phone

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

{
    "created_epoch": "1783468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1063330892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 LINCOLN WAY STE 200",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142360",
            "telephone_number": "208-664-8283",
            "fax_number": "208-667-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LINCOLN WAY STE 200",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142360",
            "telephone_number": "208-664-8283",
            "fax_number": "208-667-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOTENAI FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-08",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "LAROSE",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "208-664-8283",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Meghan Konegni, MS, RD, CSR, LD
• Carol Ann Kontos, PT
• Kootenai Audiology, LLC
• Kootenai County Emergency Medical Services System
• Kootenai Dental Group, LLC
• Kootenai Family Dental, PA
• Kootenai Health, Inc. (Kootenai Clinics Cancer Services Pharmacy)
• Kootenai Health, Inc.
• Kootenai Health, Inc. (Kootenai Health Pharmacy)
• Kootenai Health, Inc. (Kootenai Medical Center KPC Mid Level)

• Dental Clinic/Center in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.