NPIMap

Organization Active NPI

Dance Dentistry PLLC

  • General Practice Dentistry
  • Hayden, ID
National Provider Identifier
1548637994
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-4050-PD Issued in ID
Legal business name
DANCE DENTISTRY PLLC
Practice address
1027 W Prairie Ave
Hayden, ID 83835
Phone
(208) 772-2202
Fax
(208) 772-2213
NPI assigned
Sep 1, 2015
Last updated
Aug 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Authorized official

Name
Thomas Dance, DDSNPI 1518165430
Title
Owner
Phone
(208) 772-2202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D-4050-PD ID
General Practice Dentistry 1223G0001X D-4050-PD ID Primary

Addresses

Primary practice location

1027 W Prairie Ave
Hayden, ID 83835

Mailing address

1027 W Prairie Ave
Hayden, ID 83835
Phone (208) 772-2202

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1548637994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 W PRAIRIE AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-772-2202",
            "fax_number": "208-772-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 W PRAIRIE AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-772-2202",
            "fax_number": "208-772-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANCE DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "DANCE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-772-2202",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-4050-PD",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4050-PD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.