Jonathan P Dahl, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2065 Issued in ND

Practice address

1324-23Rd St. S.
Ste 1a
Fargo, ND 58103-3702

Phone

(701) 238-5616

Fax

(701) 271-8813

NPI assigned

Jan 27, 2010

Last updated

Jan 27, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dahl & Mack Dental, PC

  • Dentist
  • Fargo, ND
  • NPI 1730395435
  NPD (past) Authorized official

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1417288754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324-23RD ST. S.",
            "address_2": "STE 1A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033702",
            "telephone_number": "701-238-5616",
            "fax_number": "701-271-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324-23RD ST. S.",
            "address_2": "STE 1A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033702",
            "telephone_number": "701-238-5616",
            "fax_number": "701-271-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2065",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Dahl, FNP-C
• Claire Dahl, LMT
• Daniel W Dahl, MD
• Jamie L Dahl, LRD
• Jeanette Kay Dahl
• Kayliana Dahl
• Kevin Dahl, MD
• Lindsey Jo Dahl, M.D
• Megan Dahl
• Michell Dahl

• Dentist in Fargo, ND
• Providers in Fargo, ND by specialty
• Dentist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.