IndividualActive
Jordan Hillam, D.D.S.
NPI 1194169649 · Orthodontics and Dentofacial Orthopedics Dentistry · Idaho Falls, ID
Provider details
- NPI number
- 1194169649
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Dental Providers
Student, Health Care
Practice location
758 E 65th S
Idaho Falls, ID 83404-7696
Phone: (208) 360-9119
Approximate (ZIP-level) locationGet directions
Mailing address
758 E 65th S
Idaho Falls, ID 83404-7696
Registry dates
- Enumerated
- 2013-04-25
- Last updated
- 2018-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.