Southeast Idaho Orthodontics, Pllc
Orthodontics and Dentofacial Clinic
625 E Alameda Rd, Pocatello
Idaho, 83201-3622
208-237-0005 208-237-7982
Maps & DirectionsSoutheast Idaho Orthodontics, Pllc is a Orthodontics and Dentofacial Clinic in Pocatello, Idaho. It is located at 625 E Alameda Rd, Pocatello, ID and its contact number is 208-237-0005. The authorized person for Southeast Idaho Orthodontics, Pllc is Dr. Eric D Johnson
who is Owner of the clinic and their contact number is 208-237-0005. Other organizations associated with this clinic are Id Specialty Dental Services, Pllc, Southeast Idaho Orthodontics, Pllc, Id Sds Ii Pllc,
Southeast Idaho Orthodontics, Pllc Clinic is concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex.
Complete Clinic Profile:
Southeast Idaho Orthodontics, Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Southeast Idaho Orthodontics, Pllc |
| Specialization: | Orthodontics and Dentofacial Orthopedics |
| Clinic Address: | 625 E Alameda Rd, Pocatello,
Idaho, 83201-3622 |
| Phone: | 208-237-0005 |
| Fax: | 208-237-7982 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Eric D Johnson |
| Position: | Owner |
| Contact Number: | 208-237-0005 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Southeast Idaho Orthodontics, Pllc clinic are as mentioned below.
| NPI Number: | 1508080599 |
| NPI Enumeration Date: | 12 Apr, 2007 |
| NPI Last Update On: | 22 Aug, 2020 |
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
| Name | Specialization | NPI Number |
| Id Specialty Dental Services, Pllc | Orthodontics and Dentofacial Orthopedics | 1013757830 |
| Southeast Idaho Orthodontics, Pllc | Orthodontics and Dentofacial Orthopedics | 1508080599 |
| Id Sds Ii Pllc | Orthodontics and Dentofacial Orthopedics | 1861265647 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southeast Idaho Orthodontics, Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Orthodontics and Dentofacial Orthopedics | | | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 8042938 | Medicaid | Idaho | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Southeast Idaho Orthodontics, Pllc
625 E Alameda Rd,
Pocatello, Idaho |
| Zip: | 83201-3622 |
| Phone Number: | 208-237-0005 |
| Fax Number: | 208-237-7982 |
Patients can reach Southeast Idaho Orthodontics, Pllc at
625 E Alameda Rd, Pocatello, Idaho or can
call to book an appointment on 208-237-0005.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.