NPIMap

Organization Active NPI

Signature Idaho Dental Partners PC

Doing business as Canyon Gate Cosmetic & Family Dentistry

  • Dental Clinic/Center
  • Meridian, ID
National Provider Identifier
1124755566
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SIGNATURE IDAHO DENTAL PARTNERS PC
Doing business as
Canyon Gate Cosmetic & Family Dentistry
Coeur d'Alene Family Dentistry
Linder Road Family & Cosmetic Dentistry1 more in Other names
Practice address
1500 W Cayuse Creek Dr Ste 100
Meridian, ID 83646-4757
Phone
(208) 893-5435
NPI assigned
Aug 5, 2022
Last updated
Nov 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SIGNATURE DENTAL PARTNERS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Melody Bennion
Title
Director of Integrations
Phone
(480) 234-8490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1500 W Cayuse Creek Dr Ste 100
Meridian, ID 83646-4757

Mailing address

410 N 44TH St Ste 600
Phoenix, AZ 85008-7616
Phone (208) 893-5435

Other practice location 1

256 Martin St
Twin Falls, ID 83301-4542
Phone (208) 733-5346

Other practice location 2

188 River Vista Pl
Twin Falls, ID 83301-3056
Phone (208) 733-2090

Other practice location 3

2201 N Government Way Ste G
Coeur D Alene, ID 83814-3658
Phone (208) 664-9129

Other names 4

  • Canyon Gate Cosmetic & Family Dentistry Doing business as
  • Coeur d'Alene Family Dentistry Doing business as
  • Linder Road Family & Cosmetic Dentistry Doing business as
  • Roberts & Hall Dentistry Doing business as

National Provider Directory

National Provider Directory
Part of
Signature Dental Partners LLC

Locations

188 River Vista Pl
Twin Falls, ID 83301
Phone (208) 733-2090

256 Martin St
Twin Falls, ID 83301
Phone (208) 733-5346

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1124755566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N 44TH ST STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850087616",
            "telephone_number": "208-893-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W CAYUSE CREEK DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464757",
            "telephone_number": "208-893-5435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 Martin St",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833014542",
            "country_code": "US",
            "telephone_number": "208-733-5346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "188 River Vista Pl",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833013056",
            "country_code": "US",
            "telephone_number": "208-733-2090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 N Government Way Ste G",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838143658",
            "country_code": "US",
            "telephone_number": "208-664-9129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIGNATURE IDAHO DENTAL PARTNERS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIGNATURE DENTAL PARTNERS LLC",
        "enumeration_date": "2022-08-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "BENNION",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATIONS",
        "authorized_official_telephone_number": "480-234-8490"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Gate Cosmetic & Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coeur d'Alene Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Linder Road Family & Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Linder Road Family & Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roberts & Hall Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.