Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1700728391 Individual Practitioner

Jake Groberg

Dentist - General Practice • Pocatello, ID

Professional Overview & Biography Verified Profile Summary

Jake Groberg is a registered healthcare professional specializing in Dentist - General Practice in Pocatello, ID. Practice services are available at 465 MEMORIAL DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

465 Memorial Dr

Pocatello, ID 832014008

Telephone 2082826000
Associated Practice Facility / Clinic
🏢 Phs Md #1, Llc Facility NPI 1992032098

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

CMS Verified: 2026-06-24
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License ID 3581210

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

22 Associated Practitioners
Dr. Cory Veigel , DMD

Dentist - General Practice

NPI 1023597275

Doctor of Dental Medicine

NPI 1043105703

Doctor of Dental Surgery

NPI 1083284897
Dr. Leigh Ammon , DMD

Dentist - General Practice

NPI 1174747190

Doctor of Dental Medicine

NPI 1184294712

Doctor of Dental Surgery

Dr. Timothy Jessop , DDS

Dentist - General Practice

NPI 1245542596

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2026

Dentist (License #3581210 in ID)

NPI Profile Active April 06, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location April 06, 2026

Registered at 465 MEMORIAL DR, POCATELLO, ID 832014008 (Tel: 2082826000)

📍
Updated Business Mailing Address April 06, 2026

Registered at 465 MEMORIAL DR, POCATELLO, ID 832014008 (Tel: 2082826000)

👤
Provider Name / Credentials Updated April 06, 2026

Recorded as JAKE GROBERG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2026

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 06, 2026

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: 1700728391
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 06, 2026
Last Update: June 24, 2026
Sole Proprietor: Yes

Mailing Address

465 Memorial Dr

Pocatello, ID 832014008

Phone: 2082826000

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.