Affordable Family Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4216 Issued in ID

Legal business name

AFFORDABLE FAMILY DENTISTRY PC

Practice address

1400 E 17TH St
Idaho Falls, ID 83404-6269

Phone

(208) 881-9177

Fax

(866) 767-0878

NPI assigned

Jan 4, 2010

Organization subpart

No

Name

Dr. Tracy Dean Jenkins, DDSNPI 1659507481

Title

President

Phone

(208) 881-9177

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Dean Jenkins, D.D.S.

  • General Practice Dentistry
  • Idaho Falls, ID
  • NPI 1659507481
  NPD Authorized official General Practice

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 20, 2023.

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1245560945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046269",
            "telephone_number": "208-881-9177",
            "fax_number": "866-767-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046269",
            "telephone_number": "208-881-9177",
            "fax_number": "866-767-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-881-9177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Aebischer, LSW
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• Affiliates Inc.
• Affirm Human Services
• Aaron Jon Affleck, MD
• Agewell Connections LLC.
• Agewell Transportation LLC
• Ashley Kyle Aiton, FNP
• Alan Adamson, OD, PC
• Jessica Alba, PHARMD

• All providers in Idaho Falls, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.