Cda Kids Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CDA KIDS DENTISTRY PLLC

Practice address

1341 N Northwood Center CT Ste B
Coeur D Alene, ID 83814-2471

Phone

(208) 500-2204

Fax

(208) 619-4619

NPI assigned

Sep 28, 2021

Last updated

Sep 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Devin Morin, DMDNPI 1861927675

Title

Managing Member/Sole Member

Phone

(502) 712-9561

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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.

• Devin Morin, DMD

  • Pediatric Dentistry
  • Spokane, WA
  • NPI 1861927675
  NPD Authorized official

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1689346736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E SILVER PINE RD",
            "city": "COLBERT",
            "state": "WA",
            "postal_code": "990055125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 N NORTHWOOD CENTER CT STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142471",
            "telephone_number": "208-500-2204",
            "fax_number": "208-619-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDA KIDS DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "MORIN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "MANAGING MEMBER/SOLE MEMBER",
        "authorized_official_telephone_number": "502-712-9561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2138247",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44756",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Lorraine Caudle
• Katrina Ann Cavanaugh, APRN-CNP, RN
• Devin Traer Caywood, MD
• Lynley Peterson Cazier, CCC-SLP
• Cda Hand Therapy & Healing Center PA
• Cda PT at Home LLC
• Cda Ultrasound, Inc. (Coeur d'Alene Ultrasound)
• Traci Cellona
• Center for Behavioral Health Idaho, LLC
• Centerwell Certified Healthcare Corp. (CenterWell Home Health)

• Dental Clinic/Center in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.