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Active NPI 1215072798 Individual Practitioner Male Practitioner

Dr. Robert L Fackrell , DDS

Dentist - General Practice • Pocatello, ID

Professional Overview & Biography Verified Profile Summary

Dr. Robert Fackrell, DDS is a registered healthcare professional specializing in Dentist - General Practice in Pocatello, ID. Practice services are available at 415 N 3RD AVE STE A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

415 N 3rd Ave Ste A

Pocatello, ID 832016306

Telephone 2082332355
Fax 2082330582
Associated Practice Facility / Clinic
🏢 Robert L. Fackrell Dds Pa Facility NPI 1801225180

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Pocatello, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 50.0 Yrs
State Avg: 28.3 Yrs
Regional Practice Density
50 Specialists

Practicing in Pocatello, ID (781 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License ID D3134

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
002783500 (ID)
Commercial Insurance / Payer ID United Concordia
537818 (ID)
Commercial Insurance / Payer ID Blue Cross
000010010434 (ID)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active January 13, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location January 13, 2015

Registered at 415 N 3RD AVE STE A, POCATELLO, ID 832016306 (Tel: 2082332355)

📍
Updated Business Mailing Address January 13, 2015

Registered at 415 N 3RD AVE STE A, POCATELLO, ID 832016306 (Tel: 2082332355)

👤
Provider Name / Credentials Updated January 13, 2015

Recorded as ROBERT FACKRELL, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 13, 2015

Dentist (License #D3134 in ID)

🟢
Initial NPI Registration & Enumeration February 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215072798
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 21, 2007
Last Update: January 13, 2015
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

415 N 3rd Ave Ste A

Pocatello, ID 832016306

Phone: 2082332355

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.