Teton Oms

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

TETON OMS

Practice address

780 Bridgeport Dr
Idaho Falls, ID 83402-3370

Phone

(208) 932-4600

Fax

(208) 932-4601

NPI assigned

Jun 20, 2025

Organization subpart

No

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

Authorized official

Name

Makell Clay

Title

Practice Manager

Phone

(208) 932-4600

Specialties & licenses 2

Addresses

Other names 1

• SNAKE RIVER SURGICAL Doing business as

Locations

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1336036474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 BRIDGEPORT DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023370",
            "telephone_number": "208-932-4600",
            "fax_number": "208-932-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 BRIDGEPORT DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023370",
            "telephone_number": "208-932-4600",
            "fax_number": "208-932-4601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 E Main St",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402015",
            "country_code": "US",
            "telephone_number": "208-932-4600",
            "fax_number": "208-932-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TETON OMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "MAKELL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "208-932-4600"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SNAKE RIVER SURGICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teton Hospitalist Services, PLLC
• Teton Microbiology Laboratory
• Teton MRI of Idaho Falls
• Teton Nuclear Medicine Service LLC
• Teton Obstetrics and Gynecology PA
• Teton Outpatient, LLC
• Teton Physical Therapy, Inc
• Teton Plastic Surgery
• Teton Radiology Diagnostic a Series of Teton Group Enterprise
• Teton Radiology Diagnostic, LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.