Shane Daniel Vania, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3895 Issued in ID

Practice address

900 N Liberty St Ste 304
Boise, ID 83704-8729

Phone

(208) 407-0079

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1083642722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SUN BURST WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 304",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048729",
            "telephone_number": "208-407-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANIA",
        "first_name": "SHANE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Olivia Vangorp, PT, DPT
• Tonja Vanhees, PT
• Amber Vania, DO
• Carolina M. Vania, OTLP
• Cyrus H Vania, DO
• Devon Kathryn Vankleek
• James W Vanlooy, MD
• Charee H. Vanorder, OT
• Jade Vantrease, MD
• Julia Kelly June Vantrimpont

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.