Dentist Providers In Idaho Falls, Idaho

Search Dentist NPI records in Idaho Falls, ID

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Idaho Falls, ID. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 162, of which 54 are registered as organizations and 108 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

67% Individuals

33% Organizations

2% Female

64% Male

67% Individual Providers (108)33% Medical Organizations (54)2% Female Providers (4)64% Male Providers (104)

Map of Providers

We have mapped the Dentist providers in Idaho Falls, ID to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Idaho Falls, ID
NPI	Name	Address	Insurance	Medicare	PECOS
1003144114	SUNNYSIDE DENTAL CARE PC (Organization)	1520 ELK CREEK DR IDAHO FALLS, ID 83404 (208) 522-8854	UnitedHealthcare	Non-Participating Provider	NO
1013116979	CHRISTOPHER M CANNON (Individual)	3550 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 524-2300	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1033280136	RYAN T KIDMAN (Individual)	139 ALTURAS ST IDAHO FALLS, ID 83401 (208) 523-5090	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana PacificSource Health Plans Paramount Paramount Dental	Non-Participating Provider	YES
1033443478	SOFT TOUCH DENTAL (Organization)	3350 S 15 TH E IDAHO FALLS, ID 83404 (208) 522-4700		Non-Participating Provider	NO
1033560578	ID DENTAL ASSOCIATES, P.C. (Organization)	2818 S 25TH E IDAHO FALLS, ID 83404 (208) 243-8391	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental	Non-Participating Provider	NO
1043644388	MCCORD ORTHODONTICS (Organization)	3411 MERLIN DR IDAHO FALLS, ID 83404 (208) 529-8333		Non-Participating Provider	NO
1043904659	MONGILLO ORTHODONTICS, PLLC (Organization)	250 S SKYLINE DR STE 4 IDAHO FALLS, ID 83402 (208) 524-1404		Non-Participating Provider	NO
1053496083	DWIGHT DOUGLAS BAKER (Individual)	1900 JOHN ADAMS PKWY IDAHO FALLS, ID 83401 (208) 524-0644	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1063515062	MARK ASAEL TALL (Individual)	2460 E 25TH ST IDAHO FALLS, ID 83404 (208) 525-4780	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1063560175	RON D SHEPPARD (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1063761617	TRENT CHARLES BUEHLER (Individual)	2860 VALENCIA DR STE 100 IDAHO FALLS, ID 83404 (855) 433-6825	Anthem Blue Cross and Blue Shield	Non-Participating Provider	YES
1083707640	TAYLORVIEW DENTAL (Organization)	3315 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 522-4491		Non-Participating Provider	NO
1083818371	PHILIP R HARPER (Individual)	3550 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 524-2300	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1093981011	OWEN DENTAL, PC (Organization)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-4700		Non-Participating Provider	NO
1114126992	KEVIN RICHARD MUDROW (Individual)	333 S WOODRUFF AVE SUITE F IDAHO FALLS, ID 83401 (208) 524-2030	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental Plan of Oregon Dominion National Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Oregon Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1114255916	ELISON ORAL AND MAXILLOFACIAL SURGERY (Organization)	2588 CHANNING WAY IDAHO FALLS, ID 83404 (208) 524-3200		Non-Participating Provider	NO
1124035498	JUSTIN DENNIS BELL (Individual)	2205 CHANNING WAY SUITE A IDAHO FALLS, ID 83404 (208) 529-4484	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1124231261	DAVID EARL WILSON (Individual)	3335 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 524-3770	PacificSource Health Plans	Non-Participating Provider	NO
1134356140	RIVERWEST DENTAL, PLLC RIVERWEST DENTAL (Organization)	1655 PANCHERI DR. IDAHO FALLS, ID 83402 (208) 522-1911		Non-Participating Provider	NO
1144339326	KIRT BRUCE HILLAM (Individual)	139 ALTURAS ST IDAHO FALLS, ID 83401 (208) 523-5090		Non-Participating Provider	NO
1144720103	GRIN PLLC (Organization)	2685 CHANNING WAY IDAHO FALLS, ID 83404 (208) 522-1164		Non-Participating Provider	NO
1144896671	CRAIG DARRINGTON (Individual)	1991 W BROADWAY ST IDAHO FALLS, ID 83402 (208) 999-4746	Anthem Blue Cross and Blue Shield Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1154074623	RICHARD DEE STOKER D.M.D., PLLC (Organization)	3350 S 15TH E IDAHO FALLS, ID 83404 (208) 522-4700		Non-Participating Provider	NO
1164101754	COMMUNITY COUNCIL OF IDAHO INC (Organization)	3387 MERLIN DR IDAHO FALLS, ID 83404 (208) 281-1222		Non-Participating Provider	NO
1164219093	BRANDON THOMAS JACOBSON (Individual)	885 PANCHERI DR IDAHO FALLS, ID 83402 (208) 524-0870		Non-Participating Provider	NO
1164589982	JAMES GARL DRAKE (Individual)	1088 N SKYLINE DR IDAHO FALLS, ID 83402 (208) 524-0870	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1164615084	RILEY J. HICKS D.D.S., P.A. (Organization)	3905 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 528-6000		Non-Participating Provider	NO
1194046037	ESTHER B. MACHEN (Individual)	3500 POTOMAC WAY SUITE 200 IDAHO FALLS, ID 83404 (208) 552-0775	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1194097402	RUSSELL GUYMON ORTHODONTICS, PA (Organization)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 529-3500		Non-Participating Provider	NO
1194169649	JORDAN RODNEY HILLAM (Individual)	758 E 65TH S IDAHO FALLS, ID 83404 (208) 360-9119	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental	Non-Participating Provider	NO
1205175668	FOOTHILLS DENTAL CARE, PLLC RIVERWEST DENTAL (Organization)	1655 PANCHERI DR IDAHO FALLS, ID 83402 (208) 522-1911		Non-Participating Provider	NO
1205864832	MICHAEL AARON ELISON (Individual)	3656 WASHINGTON PARKWAY IDAHO FALLS, ID 83404 (208) 522-7216	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1215958376	OLIVER ONEAL THUERNAGLE (Individual)	1685 PANCHERI DR IDAHO FALLS, ID 83402 (208) 523-0840	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1225255748	JASON M PETERSON (Individual)	1980 1ST ST IDAHO FALLS, ID 83401 (208) 524-3400	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1225289390	RODNEY H. HILLAM (Individual)	3325 S. HOLMES AVE. IDAHO FALLS, ID 83404 (208) 524-1800		Non-Participating Provider	NO
1225325558	TODD L MATHESON (Individual)	3315 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 522-4491	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1225768476	CRAIG DARRINGTON DDS PLLC (Organization)	2460 E 25TH ST IDAHO FALLS, ID 83404 (208) 525-4780		Non-Participating Provider	NO
1235565003	KEVIN MUDROW DDS PLLC MUDROW FAMILY DENTAL (Organization)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 524-2036		Non-Participating Provider	NO
1245388354	LOREN MCKAY RICH (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383		Non-Participating Provider	NO
1245560945	AFFORDABLE FAMILY DENTISTRY PC (Organization)	1400 E 17TH ST IDAHO FALLS, ID 83404 (208) 881-9177	UnitedHealthcare	Non-Participating Provider	NO
1245601780	BRETT DUNFORD DAVIS (Individual)	3315 S HOLMES AVENUE IDAHO FALLS, ID 83404 (208) 522-4491	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	NO
1255906277	CHOICE DENTAL (Organization)	1991 W BROADWAY ST IDAHO FALLS, ID 83402 (208) 999-4746		Non-Participating Provider	NO
1265056121	JACOB TALL (Individual)	2460 E 25TH ST IDAHO FALLS, ID 83404 (208) 525-4780	Anthem Blue Cross and Blue Shield	Non-Participating Provider	YES
1265580377	CHARLES HUNTER (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. PacificSource Health Plans Paramount Paramount Dental	Non-Participating Provider	NO
1265604995	STEVEN ABBOTT BARNARD (Individual)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1275640443	LORIN E DIXON (Individual)	205 ELM ST STE A IDAHO FALLS, ID 83402 (208) 524-2771	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1275795395	MARK A. TALL, P.A. SANDCREEK DENTAL (Organization)	2460 E 25TH ST IDAHO FALLS, ID 83404 (208) 525-4780		Non-Participating Provider	NO
1285318311	KOLBY TRONIER KLINGLER (Individual)	1655 PANCHERI DR IDAHO FALLS, ID 83402 (208) 522-1911	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1285653071	BRANT N OLSON (Individual)	250 S SKYLINE DR SUITE 5 IDAHO FALLS, ID 83402 (208) 522-9101	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1285703900	COREY D. CHRISTENSEN (Individual)	2205 CHANNING WAY IDAHO FALLS, ID 83404 (208) 529-3660	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Wyoming Florida Combined Life Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1295021632	BLAINE A HAMMOND (Individual)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400	Ambetter from Home State Health Ambetter from Nebraska Total Care Ambetter from NH Healthy Families Ambetter from Sunflower Health Plan Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Iowa Dentegra Insurance Company Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1295317097	MICHAEL MEEK SHARP (Individual)	2194 SNAKE RIVER PKWY STE 101 IDAHO FALLS, ID 83402 (208) 757-6245	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1295995652	VERNON O. GAFFNER, D.M.D., P.A. (Organization)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 524-2034		Non-Participating Provider	NO
1306053350	LAYNE K MCCORD (Individual)	1943 MADISON AVE IDAHO FALLS, ID 83404 (208) 529-8333	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1306915046	JEFFREY A. HOOVER (Individual)	2205 CHANNING WAY SUITE B IDAHO FALLS, ID 83404 (208) 529-3660	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1306973862	RODNEY H HILLAM DDS MS PA (Organization)	3325 S HOLMES AVE IDAHO FALLS, ID 83404 (206) 524-1800		Non-Participating Provider	NO
1316670698	RICHARD DUKE DAVIS (Individual)	1980 1ST ST IDAHO FALLS, ID 83401 (208) 350-3897		Non-Participating Provider	NO
1326196437	ROBERT HUNTER (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1326395385	EAGLE ROCK DENTAL CARE PLLC (Organization)	2205 CHANNING WAY STE B IDAHO FALLS, ID 83404 (208) 529-3660		Non-Participating Provider	NO
1336224633	G. VAN STOSICH (Individual)	1400 E 17TH ST IDAHO FALLS, ID 83404 (208) 522-8061	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1336498120	RICHARD DEE STOKER D.M.D., PLLC (Organization)	3350 S 15TH E IDAHO FALLS, ID 83404 (208) 522-4700		Non-Participating Provider	NO
1356465660	EAGLE ROCK DENTAL CARE (Organization)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400		Non-Participating Provider	NO
1356795843	AUSTIN FRENCH (Individual)	929 S UTAH AVE IDAHO FALLS, ID 83402 (208) 529-2199	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1376336925	WILLOW CREEK DENTAL (Organization)	1380 LATAH AVENUE, IDAHO FALLS, ID IDAHO FALLS, ID 83402 (208) 552-0919		Non-Participating Provider	NO
1376555292	CHANNING WAY DENTAL CARE (Organization)	2205 CHANNING WAY SUITE B IDAHO FALLS, ID 83404 (208) 529-3660		Non-Participating Provider	NO
1376627802	VERNON O GAFFNER (Individual)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 524-2034		Non-Participating Provider	NO
1376684175	SCOTT M BLAKE (Individual)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-2160	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana	Non-Participating Provider	YES
1376718460	RICHARD D STOKER (Individual)	1520 ELK CREEK DR IDAHO FALLS, ID 83404 (208) 522-4700	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1376876110	KENT CUTFORTH DDS (Organization)	1370 E. 17TH STREET IDAHO FALLS, ID 83404 (208) 523-3388		Non-Participating Provider	NO
1376969360	THOMAS BAKER (Individual)	1900 JOHN ADAMS PKWY IDAHO FALLS, ID 83401 (208) 524-0644	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Wyoming Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1396909347	CHRISTOPHER DARREL HANSEN (Individual)	3550 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 524-2300	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1407085467	JUSTIN FRANDSEN (Individual)	3375 MERLIN DR IDAHO FALLS, ID 83404 (208) 524-1700	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1407211725	BAKER PEDIATRIC DENTISTRY, PLLC BAKER PEDIATRIC DENTISTRY (Organization)	1900 JOHN ADAMS PKWY IDAHO FALLS, ID 83401 (208) 524-0644	Blue Cross Blue Shield of Wyoming UnitedHealthcare	Non-Participating Provider	NO
1407961329	MICHAEL ALDON TALL (Individual)	3381 MERLIN DR IDAHO FALLS, ID 83404 (208) 522-1332	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Renaissance Dental	Non-Participating Provider	NO
1417034190	LYLE KRIS MUNK (Individual)	2588 CHANNING WAY IDAHO FALLS, ID 83404 (208) 524-3200	Ambetter from Arizona Complete Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana	Non-Participating Provider	NO
1417090051	MELISSA A DIXON (Individual)	205 ELM ST IDAHO FALLS, ID 83402 (208) 524-2771	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1417158791	JOSEPH MATTHEW ELISON (Individual)	3357 MERLIN DR IDAHO FALLS, ID 83404 (208) 522-9600	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1417641374	AARON MARK CAPENER (Individual)	4810 E SAGEWOOD CIR IDAHO FALLS, ID 83406 (208) 709-7255	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1427106533	KIRK R TINGEY (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383		Non-Participating Provider	NO
1427618958	EASTERN IDAHO ENDODONTICS (Organization)	3335 S. HOLMES AVE IDAHO FALLS, ID 83404 (208) 524-3770		Non-Participating Provider	NO
1427626779	WILLIAM KENNETH KLINGLER (Individual)	2205 CHANNING WAY STE A IDAHO FALLS, ID 83404 (208) 529-4484	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1437595881	JORDAN E. HIGHAM PA JUST 4 KIDDS DENTISTRY FOR CHILDREN (Organization)	929 S UTAH AVE IDAHO FALLS, ID 83402 (208) 529-2199	UnitedHealthcare	Non-Participating Provider	NO
1437684099	HILLAM ORTHODONTICS PA (Organization)	3325 S. HOLMES AVE. IDAHO FALLS, ID 83404 (208) 524-1800		Non-Participating Provider	NO
1437750809	JOSHUA M MURPHY (Individual)	1580 ELK CREEK DR. IDAHO FALLS, ID 83404 (208) 522-4552	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1447343124	BRENT JOHNSON SIMPSON (Individual)	2960 CORTEZ IDAHO FALLS, ID 83404 (208) 529-0999		Non-Participating Provider	NO
1477023778	GREGORY MCGEE, DMD IDAHO FALLS ORAL AND FACIAL SURGERY (Organization)	3905 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 528-6000	UnitedHealthcare	Non-Participating Provider	NO
1487729901	ROBERT DEE NIELSON (Individual)	3151 17TH STREET IDAHO FALLS, ID 83406 (208) 529-3836	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1497142350	OXFORD DENTAL CARE (Organization)	749 OXFORD DR IDAHO FALLS, ID 83401 (208) 529-0420		Non-Participating Provider	NO
1497803696	IDAHO FALLS DENTAL GROUP (Organization)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	UnitedHealthcare	Non-Participating Provider	NO
1508427642	JENNIFER LINDZI AABERG (Individual)	2818 S 25TH E IDAHO FALLS, ID 83404 (208) 243-8391	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1518990241	CURTIS JOHN GODFREY (Individual)	2515 CHANNING WAY IDAHO FALLS, ID 83404 (208) 529-4321	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1528116639	REX D THOMPSON (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas PacificSource Health Plans Paramount Paramount Dental	Non-Participating Provider	YES
1528879129	ROOT & BRANCH ANESTHESIA P.L.L.C. (Organization)	3335 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 524-3770		Non-Participating Provider	NO
1538135371	DUANE KENT GODFREY (Individual)	2515 CHANNING WAY IDAHO FALLS, ID 83404 (208) 529-4321		Non-Participating Provider	NO
1538399316	BRODIE STEVEN ATWOOD (Individual)	1759 W BROADWAY ST IDAHO FALLS, ID 83402 (208) 313-0520	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1538973359	SUNNYSIDE DENTAL CARE LLC (Organization)	1520 ELK CREEK DR IDAHO FALLS, ID 83404 (208) 522-4700		Non-Participating Provider	NO
1558534917	ALAN RAY COOPER (Individual)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1588757223	VAL HEBER BINGHAM (Individual)	3387 MERLIN DR IDAHO FALLS, ID 83404 (208) 227-0382	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1598053712	BRET E. MOOSO D.D.S.,M.S. MOOSO ORTHODONTICS (Organization)	1580 ELK CREEK DRIVE IDAHO FALLS, ID 83404 (208) 522-4552		Non-Participating Provider	NO
1609247147	LAUREN ASHLEY DAVIS (Individual)	3315 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 522-4491	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Renaissance Dental	Non-Participating Provider	NO
1609478080	ANDREW JOSEPH HIGHAM (Individual)	929 S UTAH AVE IDAHO FALLS, ID 83402 (208) 529-2199	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1609552371	ADAM J LOWE (Individual)	200 N WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 529-0120	Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1609952415	JOSHUA REID BELL (Individual)	2205 CHANNING WAY SUITE A IDAHO FALLS, ID 83404 (208) 529-4484	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1609977891	JOHN OWEN (Individual)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-4700	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1619010477	VERN BARRY BRUGGEMAN (Individual)	333 SO WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 524-2036		Non-Participating Provider	NO
1629696810	JAMES RICHEY (Individual)	2205 CHANNING WAY IDAHO FALLS, ID 83404 (208) 529-4484	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1639263072	SCOTT D DAVIS (Individual)	3315 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 522-4491	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	NO
1649300609	STEVEN J. LARSEN (Individual)	1088 N SKYLINE DR IDAHO FALLS, ID 83402 (208) 524-0870		Non-Participating Provider	NO
1649610726	IDAHO FALLS SMILES, PLLC (Organization)	3375 MERLIN DR IDAHO FALLS, ID 83404 (208) 524-1700		Non-Participating Provider	NO
1649925561	DAVID J BINGHAM (Individual)	3335 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 524-3770	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas UnitedHealthcare	Non-Participating Provider	YES
1659507481	TRACY DEAN JENKINS (Individual)	1400 E 17TH ST IDAHO FALLS, ID 83404 (208) 881-9177	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1659590693	BART BATY MORRISON (Individual)	3335 S HOLMES AVE IDAHO FALLS, ID 83404 (208) 524-3770	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1669886982	ANTHONY MONGILLO (Individual)	250 S SKYLINE DR STE 4 IDAHO FALLS, ID 83402 (208) 524-1404	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Wyoming Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1679098008	JOSHUA LEWIS (Individual)	675 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 538-0104	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1679745269	FAMLIY DENTAL HEALTH CENTER BURTENSHAW CRAIG A & G STALEY GPS (Organization)	200 N WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 529-0120	UnitedHealthcare	Non-Participating Provider	NO
1679860829	MACHEN FAMILY DENTISTRY PC (Organization)	3500 POTOMAC WAY SUITE 200 IDAHO FALLS, ID 83404 (208) 552-0775	UnitedHealthcare	Non-Participating Provider	NO
1699463919	WESTON DEAN KILLPACK (Individual)	7708 S 8TH W IDAHO FALLS, ID 83402 (208) 821-2250		Non-Participating Provider	NO
1699725465	BRYCE A. BURTENSHAW (Individual)	200 N WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 529-0120	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1699935353	SCOTT T ALLEN (Individual)	3815 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 529-4500	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1700954518	GARY J NELSON (Individual)	3350 S 15TH E IDAHO FALLS, ID 83404 (208) 522-4700		Non-Participating Provider	NO
1710186432	JORDAN HIGHAM (Individual)	929 S UTAH AVE IDAHO FALLS, ID 83402 (208) 529-2199	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1710188081	JOSEPH HYRUM ELISON (Individual)	3357 MERLIN DR IDAHO FALLS, ID 83404 (208) 522-9600	Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1740215870	ELISON ORTHODONTICS PLLC JOSEPH H. ELISON AND/OR JOSEPH MATTHEW ELISON (Organization)	3357 MERLIN DR IDAHO FALLS, ID 83404 (208) 522-9600	UnitedHealthcare	Non-Participating Provider	NO
1740222579	ETHAN D. MOULTON (Individual)	2375 E SUNNYSIDE RD STE I IDAHO FALLS, ID 83404 (208) 522-6683		Non-Participating Provider	NO
1740501410	TYSON R MURDOCK (Individual)	2205 CHANNING WAY SUITE A IDAHO FALLS, ID 83404 (208) 529-4484	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1750747077	MATT MCCOY (Individual)	3411 MERLIN DR IDAHO FALLS, ID 83404 (801) 440-6849	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1760406193	DAVID M HENINGER (Individual)	3375 MERLIN DR IDAHO FALLS, ID 83404 (208) 524-1700	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1760654487	DOUGLAS STEVEN BARNARD (Individual)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1760686679	HARRIS DENTAL (Organization)	3815 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 529-4500		Non-Participating Provider	NO
1780355453	KISTLER DENTAL PLLC (Organization)	2818 S 25TH E IDAHO FALLS, ID 83404 (208) 243-8391		Non-Participating Provider	NO
1790092468	JEFF YBARGUEN (Individual)	3423 MERLIN DR STE 100 IDAHO FALLS, ID 83404 (208) 542-9900	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1801944913	JOHN MEMMOTT (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1811057623	BRETT DEAN JACOBSON (Individual)	1088 N SKYLINE DR IDAHO FALLS, ID 83402 (208) 524-0870	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1811157001	NICHOLAS J TANNER (Individual)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1821047432	GALEN J. STALEY (Individual)	200 N WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 529-0120	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1821130253	JEFFREY W JOHNSON (Individual)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 529-3500	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah UnitedHealthcare	Non-Participating Provider	NO
1821260555	CADE GRIMMETT BALDWIN (Individual)	640 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-5400	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Select Health UnitedHealthcare	Non-Participating Provider	YES
1831287523	WILLIAM EDWIN PEARSON (Individual)	749 OXFORD DR IDAHO FALLS, ID 83401 (208) 529-0420	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1841204609	LEGACY DENTAL (Organization)	1685 PANCHERI DR IDAHO FALLS, ID 83402 (208) 523-0840	UnitedHealthcare	Non-Participating Provider	NO
1851130199	CHANDLER J BELL (Individual)	1655 PANCHERI DR IDAHO FALLS, ID 83402 (208) 522-1911		Non-Participating Provider	NO
1851438709	JAY M. HARRIS (Individual)	3815 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 529-4500		Non-Participating Provider	NO
1851449003	ELITE DENTAL CARE, PLLC (Organization)	3423 MERLIN DR SUITE 100 IDAHO FALLS, ID 83404 (208) 542-9900		Non-Participating Provider	NO
1851590152	MARK AARON CHAMBERS (Individual)	2860 VALENCIA DR STE 101 IDAHO FALLS, ID 83404 (208) 524-7055	Anthem Blue Cross and Blue Shield	Non-Participating Provider	YES
1871931246	DEVIN REX THOMPSON (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1881602266	EXCELLENCE IN DENTISTRY PA (Organization)	2515 CHANNING WAY IDAHO FALLS, ID 83404 (208) 529-4321	UnitedHealthcare	Non-Participating Provider	NO
1881789550	BRAD L OSWALD (Individual)	3456 E 17TH ST SUITE 115 IDAHO FALLS, ID 83406 (208) 522-1234	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1891487872	LEWIS DENTAL SERVICES (Organization)	675 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 270-0301		Non-Participating Provider	NO
1891756367	GREGORY R MCGEE (Individual)	3905 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 528-6000	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Wyoming Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Accepts Medicare	YES
1891756599	EVAN O JOHNSON (Individual)	1520 ELK CRK IDAHO FALLS, ID 83404 (208) 522-8854	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1891844379	BRACKEN WEBB (Individual)	2300 E 17TH ST IDAHO FALLS, ID 83404 (208) 525-8383	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas PacificSource Health Plans	Non-Participating Provider	YES
1902902208	BRETT EDDIS MOOSO (Individual)	1410 E 17TH ST IDAHO FALLS, ID 83404 (208) 522-4552	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1902949969	PHILLIP DAVID LOWDER (Individual)	250 SOUTH SKYINE DRIVE STE 4 IDAHO FALLS, ID 83402 (208) 524-1404	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1912114273	EASTERN IDAHO PUBLIC HEALTH DISTRICT (Organization)	1250 HOLLIPARK DR IDAHO FALLS, ID 83401 (208) 522-0310		Non-Participating Provider	NO
1912289885	RODNEY CORDELL JOHNS (Individual)	2818 S 25TH E IDAHO FALLS, ID 83404 (208) 243-8391	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DeltaCare USA Regence BlueCross BlueShield of Utah UnitedHealthcare	Non-Participating Provider	NO
1922165216	MATHEW GREG PALMER (Individual)	3387 MERLIN DR IDAHO FALLS, ID 83404 (608) 752-6848	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Paramount Paramount Dental	Non-Participating Provider	NO
1932368222	ELISON DENTAL CENTER (Organization)	3656 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 522-7216	UnitedHealthcare	Non-Participating Provider	NO
1942508361	HARRIS & ALLEN DENTAL (Organization)	3815 WASHINGTON PKWY IDAHO FALLS, ID 83404 (208) 529-4500		Non-Participating Provider	NO
1952316341	ASPEN VALLEY FAMILY DENTISTRY MARCUS NEFF DDS (Organization)	3423 MERLIN DRIVE SUITE 100 IDAHO FALLS, ID 83404 (208) 523-4181		Non-Participating Provider	NO
1952317703	WAYNE BERNELL MURDOCK (Individual)	2205 CHANNING WAY SUITE A IDAHO FALLS, ID 83404 (208) 529-4484		Non-Participating Provider	NO
1952663460	TRENT MERRILL KELLY (Individual)	1991 W BROADWAY ST IDAHO FALLS, ID 83402 (208) 999-4746	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1962664383	DIXON DENTAL CENTER LORIN E. DIXON, D.M.D. (Organization)	205 ELM ST SUITE A IDAHO FALLS, ID 83402 (208) 524-2771		Non-Participating Provider	NO
1972779916	SCOTT M. BLAKE, DDS, PC (Organization)	333 S WOODRUFF AVE IDAHO FALLS, ID 83401 (208) 523-2160		Non-Participating Provider	NO

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