Chandler Bozarth, DDS
Individual provider Active NPI Dentist · Coeur D Alene, ID
NPI 1497434823 · NPPES record last updated Mar 17, 2026
Key facts
- NPI
- 1497434823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6471081 (ID)
- Practice address
- 1090 W Park PL Ste B
Coeur D Alene, ID 83814-2785 - Phone
- (208) 292-0697
- NPI assigned
- Jul 13, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- Loma Linda University School of Dentistry, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 1387
Hayden, ID 83835
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251227000441 | ID | Practitioner - Dentist | 0446746531 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6471081 | ID | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dirne Health Centers, Inc. | Current |
Accepting new patients | |
| Dirne Health Centers, Inc. | Current |
Accepting new patients | |
| Dr Edward a Kahn PLLC | General Practice | Past |
Accepting new patients |
Locations
1090 W Park Pl
Ste B
Coeur D Alene, ID 83814
Phone (208) 292-0303
1090 W Park Pl
Coeur D Alene, ID 83814
Phone (208) 215-2005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6471081 | ID | Yes |
Addresses
Primary practice location
1090 W Park PL Ste B
Coeur D Alene, ID 83814-2785
Mailing address
1090 W Park PL
Coeur D Alene, ID 83814-2785
Phone (870) 219-4969
Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.