OrganizationActive
Id Sds II PLLC
NPI 1538909379 · Orthodontics and Dentofacial Orthopedics Dentistry · Boise, ID
Provider details
- NPI number
- 1538909379
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Parent organization
- Id Specialty Dental Services, PLLC
- Organization subpart
- Yes
- Authorized official
- Charlotte Dasch, Director of Credentialing(504) 638-0303
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
1541 S Timesquare Ln
Boise, ID 83709-8266
Phone: (208) 321-7006
Street-level locationGet directions
Mailing address
1610 54th Ave N Ste 205
Nashville, TN 37209-1442
Other names (DBA / former)
- Doing business as
- Super Smiles Orthodontics
- Doing business as
- Super Smiles Orthodontics
Additional practice locations (1)
- 450 E State St Ste 100Eagle, ID 83616-5030Phone: (208) 393-2311
Registry dates
- Enumerated
- 2024-05-29
- Last updated
- 2025-03-03
- Certified
- 2025-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.