Pocatello Dental Excellence

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

POCATELLO DENTAL EXCELLENCE

Practice address

1525 Baldy Ave
Pocatello, ID 83201-7117

Phone

(208) 238-0011

NPI assigned

May 26, 2023

Organization subpart

No

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

Authorized official

Name

Kyle Frost, DDSNPI 1750035713

Title

Dentist

Phone

(208) 521-3449

Specialties & licenses 1

Addresses

Other names 1

• Dental Excellence Doing business as

Locations

Practitioners 1

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

• Kyle Bolin Frost, DDS

  • General Practice Dentistry
  • Boston, MA
  • NPI 1750035713
  NPD Authorized official

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1366134397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 BALDY AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832017117",
            "telephone_number": "208-238-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 BALDY AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832017117",
            "telephone_number": "208-238-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCATELLO DENTAL EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-521-3449",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Excellence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pocatello Children & Adolescent Clinic
• Pocatello Children'S Clinic
• Pocatello Chubbuck School District #25
• Pocatello Clinic of Internal Medicine PA
• Pocatello Community Charter School
• Pocatello Family Medicine
• Pocatello Free Clinic
• Pocatello Health Services, Inc.
• Pocatello Health Services, Inc.
• Pocatello Health Services, LLC

• Dental Clinic/Center in Pocatello, ID
• Providers in Pocatello, 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 May 26, 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.