Eric N Dahle, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D6574 Issued in OR

Practice address

478 SW 12TH St
Ontario, OR 97914-3202

Phone

(541) 881-1794

Fax

(541) 889-2904

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1376536649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 SW 12TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143202",
            "telephone_number": "541-881-1794",
            "fax_number": "541-889-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 SW 12TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143202",
            "telephone_number": "541-881-1794",
            "fax_number": "541-889-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLE",
        "first_name": "ERIC",
        "middle_name": "N",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D6574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095182",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001716300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6689990001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reyna Sabina Cuevas
• Jay Asqel Cummins
• Kelsey Curtis
• Sarah Grady Dagnan
• Daniel Jon Dahle, DDS
• Kaitana Martinez Dahle
• Gary M. Daily, MA, EDS
• Christine Eileen Davenport-Welter, MD, MPH
• Angela Davis
• Bodie Lee Davis

• Dentist in Ontario, OR
• Providers in Ontario, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.