OrganizationActive
Intermountain Dental Specialists
NPI 1134522535 · Dental Clinic/Center · Boise, ID
Provider details
- NPI number
- 1134522535
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jerry Carbone, Managing Member(208) 917-2855
- License
- D3642EN (ID)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12249 W Mcmillan Rd
Boise, ID 83713-0555
Phone: (208) 917-2855
Street-level locationGet directions
Mailing address
12249 W Mcmillan Rd
Boise, ID 83713-0555
Registry dates
- Enumerated
- 2014-09-30
- Last updated
- 2014-09-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.