Id SDS II PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

ID SDS II PLLC

Doing business as

Idaho Orthodontics
Treasure Valley Orthodontics

Practice address

625 E Alameda Rd
Pocatello, ID 83201-3622

Phone

(208) 237-0005

NPI assigned

Nov 2, 2023

Last updated

Mar 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charlotte E Vial

Title

Direc of Cred and Prov Rel

Phone

(615) 638-0303

Specialties & licenses 1

Addresses

Other names 2

• Idaho Orthodontics Doing business as
• Treasure Valley Orthodontics Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carter Burke Maughan, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pocatello, ID
  • NPI 1801632070
  NPD (past)
• Jeffrey T McMinn, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pocatello, ID
  • NPI 1942424916
  NPD (past)
• Samuel G. Smith, D.M.D.,M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boise, ID
  • NPI 1013920313
  NPD (past)

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1861265647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E ALAMEDA RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013622",
            "telephone_number": "208-237-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1541 S Timesquare Ln",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837098266",
            "country_code": "US",
            "telephone_number": "208-321-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "371 E Chubbuck Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Chubbuck",
            "state": "ID",
            "postal_code": "832021817",
            "country_code": "US",
            "telephone_number": "208-237-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 S. 3rd St. W",
            "address_purpose": "LOCATION",
            "city": "Soda Springs",
            "state": "ID",
            "postal_code": "83276",
            "country_code": "US",
            "telephone_number": "208-237-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 S. 3rd St. W",
            "address_purpose": "LOCATION",
            "city": "Soda Springs",
            "state": "ID",
            "postal_code": "83276",
            "country_code": "US",
            "telephone_number": "208-237-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1169 Parkway Dr",
            "address_purpose": "LOCATION",
            "city": "Blackfoot",
            "state": "ID",
            "postal_code": "832211652",
            "country_code": "US",
            "telephone_number": "208-237-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 S Main St Apt 16",
            "address_purpose": "LOCATION",
            "city": "Malad City",
            "state": "ID",
            "postal_code": "832521405",
            "country_code": "US",
            "telephone_number": "208-237-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 E State St",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836165030",
            "country_code": "US",
            "telephone_number": "208-939-2311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ID SDS II PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "VIAL",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIREC OF CRED AND PROV REL",
        "authorized_official_telephone_number": "615-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Treasure Valley Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Treasure Valley Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua James Huntsman, LPC
• Justin Huntsman
• Courtney Hurlbut
• Stephen Charles Hurley, PHARM.D.
• Yesenia Ruby Ibarra, LCSW
• Id Specialty Dental Services, PLLC (Idaho Orthodontics)
• Idaho Center for Oral and Facial Surgery
• Idaho Dept of Health & Welfare Esc Region 6
• Idaho Dept of Health & Welfare Itp Region 6
• Idaho Dept of Health & Welfare Reg 6 Amh Clinic Poc

• Orthodontics and Dentofacial Orthopedics Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.