OrganizationActive
Russell Guymon Orthodontics, PA
NPI 1194097402 · Orthodontics and Dentofacial Orthopedics Dentistry · Idaho Falls, ID
Provider details
- NPI number
- 1194097402
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Russell Guymon, Owner/Orthodontist(208) 529-3500
- License
- D-4402-OR (ID)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
333 S Woodruff Ave
Idaho Falls, ID 83401-4322
Phone: (208) 529-3500
Street-level locationGet directions
Mailing address
333 S Woodruff Ave
Idaho Falls, ID 83401-4322
Registry dates
- Enumerated
- 2012-02-01
- Last updated
- 2012-02-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.