Active NPI
Eva C Dahl, DDS
- Endodontics
- Onalaska, WI
National Provider Identifier
1447698451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 5001745-015
- Practice address
- 2700 National Dr Ste 1
Onalaska, WI 54650-6708 - Phone
- (608) 783-3636
- Fax
- (608) 783-3639
- NPI assigned
- Jun 12, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 5001745-015 | WI | Primary |
Addresses
Primary practice location
2700 National Dr Ste 1
Onalaska, WI 54650-6708
Mailing address
2700 National Dr Ste 1
Onalaska, WI 54650-6708
Phone (608) 783-3636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131003000073 | WI | Order and Referring Only - Oral Surgery | 6103050208 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5001745-015 | WI | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370995200000",
"number": "1447698451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 NATIONAL DR STE 1",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546506708",
"telephone_number": "608-783-3636",
"fax_number": "608-783-3639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 NATIONAL DR STE 1",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546506708",
"telephone_number": "608-783-3636",
"fax_number": "608-783-3639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "EVA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-12",
"last_updated": "2013-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WI",
"license": "5001745-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.