Idaho Dental Professionals, P.C.
NPI 1114532645ActiveOrganization· Dentist, General Practice· Boise, ID
Dentist, General Practice in Boise, Idaho, registered in NPPES in September 2020, part of Heartland Dental. The authorized official on file is Tabatha Lemke, Credentialing Coordinator.
Overview
| NPI | 1114532645 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Heartland Dental |
| NPI issued | Sep 11, 2020 |
| Last updated in NPPES | Sep 11, 2020 |
| Certified by provider | Sep 10, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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