Individual provider Active NPI

David M Denton, M.D.

  • Pediatric Adolescent Medicine Physician
  • Pocatello, ID
National Provider Identifier
1558363341
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
M-7586 Issued in ID
Practice address
1151 Hospital Way
Building F
Pocatello, ID 83201-5091
Phone
(208) 232-1443
Fax
(208) 239-3434
NPI assigned
Aug 11, 2005
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X M-7586 ID Primary

Addresses

Primary practice location

1151 Hospital Way
Building F
Pocatello, ID 83201-5091

Mailing address

1151 Hospital Way
Building F
Pocatello, ID 83201-5091
Phone (208) 232-1443

Other identifiers 1

IdentifierTypeStateIssuer
805197600MedicaidID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@pocatellochildren.opdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001663 ID Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4082893219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-7586IDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Children & Adolescent Clinic Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: admin@pocatellochildren.opdirect.net
  • Direct secure messaging: ddenton261715@ahs.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1558363341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 HOSPITAL WAY",
            "address_2": "BUILDING F",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015091",
            "telephone_number": "208-232-1443",
            "fax_number": "208-239-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 HOSPITAL WAY",
            "address_2": "BUILDING F",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015091",
            "telephone_number": "208-232-1443",
            "fax_number": "208-239-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTON",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "ID",
            "license": "M-7586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805197600",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@pocatellochildren.opdirect.net",
            "affiliation": "N",
            "address_1": "1151 Hospital Way",
            "address_2": "Building F",
            "city": "Pocatello",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832015091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.