Kory Bingham, DDS
Individual provider Active NPI Pediatric Dentistry · Rigby, ID
NPI 1124183207 · NPPES record last updated Dec 16, 2025
Key facts
- NPI
- 1124183207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- D-3493-PD (ID)
- Practice address
- 688 Rigby Lake Dr Ste 4
Rigby, ID 83442-1285 - Phone
- (208) 745-2010
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-3493-PD | ID | MD | Pediatric Dentist |
| DE00009846 | WA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Childs Smile | Pediatric Dentistry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 1361 | WY | |
| Pediatric Dentistry | 1223P0221X | DE00009846 | WA | |
| Pediatric Dentistry | 1223P0221X | D-3493-PD | ID | Yes |
Addresses
Primary practice location
688 Rigby Lake Dr Ste 4
Rigby, ID 83442-1285
Mailing address
688 Rigby Lake Dr Ste 4
Rigby, ID 83442-1285
Phone (208) 716-9724
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1090892 | Medicaid | WA |
Other providers in Rigby, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.