Individual provider Active NPI

David D Dachs, DDS

  • General Practice Dentistry
  • Great Falls, MT
National Provider Identifier
1063488674
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1621 Issued in MT
Practice address
202 2ND Street South
Suite 203
Great Falls, MT 59401-8390
Phone
(406) 791-9267
Fax
(406) 791-9277
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1621 MT Primary

Addresses

Primary practice location

202 2ND Street South
Suite 203
Great Falls, MT 59401-8390

Mailing address

202 2ND Street South
Suite 203
Great Falls, MT 59401-8390
Phone (406) 791-9267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229002986 MT Order and Referring Only - DentistPractitioner - Dentist 1254636228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1621MTMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1063488674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 2ND STREET SOUTH",
            "address_2": "SUITE 203",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594018390",
            "telephone_number": "406-791-9267",
            "fax_number": "406-791-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 2ND STREET SOUTH",
            "address_2": "SUITE 203",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594018390",
            "telephone_number": "406-791-9267",
            "fax_number": "406-791-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACHS",
        "first_name": "DAVID",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.