Jared Worthington, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9671742 Issued in ID

Practice address

621 Jensen Grove Dr
Blackfoot, ID 83221-1685

Phone

(435) 668-9919

NPI assigned

May 21, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1861067993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 JENSEN GROVE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 JENSEN GROVE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211685",
            "telephone_number": "435-668-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "JARED",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "9671742",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "10905",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "9671742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jdee Ryan Wilson, MD
• Patricia Joyce Wolfley, M.S., CCC-SLP
• Sharee Julett Wolfley
• David Woodbury, PA
• Meghan L Woolstenhulme
• Wray Dermatology
• Adam Wray, DO
• Amanda Wray, RPH
• Lee Brock Wren, OD
• Shawn A Wren, CRNA

• Pediatric Dentistry in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.