Individual provider Active NPI

Kailey Anne Smith Housley, DDS

  • Pediatric Dentistry
  • Ammon, ID
National Provider Identifier
1831504125
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D-5011-PD Issued in ID
Practice address
3015 Eagle Dr
Ammon, ID 83406-1273
Phone
(208) 419-3622
Fax
(208) 419-3461
NPI assigned
Jun 25, 2014
Last updated
May 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS040777 PA
Pediatric Dentistry 1223P0221X D-5011-PD ID Primary

Addresses

Primary practice location

3015 Eagle Dr
Ammon, ID 83406-1273

Mailing address

3015 Eagle Dr
Ammon, ID 83406-1273
Phone (208) 419-3622

Other names 1

  • Kailey Anne Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D-5011-PDIDMDPediatric Dentist
DS040777PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny Smiles Pediatric Dentistry PLLC Pediatric Dentistry CurrentSince Jun 3, 2025 Accepting new patients
Idaho Falls Pediatric Dentistry, PLLC Pediatric Dentistry CurrentSince Jun 3, 2025 Accepting new patients

Locations

3015 Eagle Dr
Ammon, ID 83406
Phone (208) 419-3622

3387 Merlin Dr
Idaho Falls, ID 83404
Phone (208) 227-0382

Organizations & group practices 2

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1831504125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-419-3622",
            "fax_number": "208-419-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-419-3622",
            "fax_number": "208-419-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSLEY",
        "first_name": "KAILEY",
        "middle_name": "ANNE SMITH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS040777",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D-5011-PD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILEY",
            "last_name": "SMITH",
            "middle_name": "ANNE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.