Individual provider Active NPI

Christine L Dahl, DDS

  • Dentist
  • Bettendorf, IA
National Provider Identifier
1730345661
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
06583 Issued in IA
Practice address
25185 Valley Dr
Bettendorf, IA 52722-7319
Phone
(563) 505-1350
NPI assigned
Jul 30, 2008
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1002000-15 WI
Dentist 122300000X 019.031931 IL
Dentist 122300000X 06583 IA Primary

Addresses

Primary practice location

25185 Valley Dr
Bettendorf, IA 52722-7319

Mailing address

25185 Valley Dr
Bettendorf, IA 52722-7319
Phone (563) 505-1350

Other practice location 1

2515 Maplecrest Road
Bettendorf, IA 52722
Phone (563) 332-1600 ext. 104

Other practice location 2

3813 E Calumet St # B
Appleton, WI 54915-4158
Phone (920) 993-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102001142 IA Practitioner - Dentist 8527386218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06583IAMDDentist
019.031931ILMDDentist
1002000-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peoples Community Health Clinic, Inc. Single Specialty CurrentSince May 28, 2024 Accepting new patients
Peoples Community Health Clinic, Inc CurrentSince May 28, 2024 Accepting new patients
Peoples Community Health Clinic, Inc Single Specialty Current Accepting new patients
Bettendorf Dental PC General Practice Past Accepting new patients
Applewhite Dental Iowa PC Dentist Past Accepting new patients

Locations

905 Franklin St
Waterloo, IA 50703
Phone (319) 272-4300

Interoperability endpoints

  • Direct secure messaging: cdahl710080@direct.ochin.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1730345661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25185 VALLEY DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227319",
            "telephone_number": "563-505-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25185 VALLEY DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227319",
            "telephone_number": "563-505-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2515 Maplecrest Road",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "52722",
            "country_code": "US",
            "telephone_number": "563-332-1600 x104",
            "fax_number": "563-332-2219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3813 E Calumet St # B",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549154158",
            "country_code": "US",
            "telephone_number": "920-993-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "CHRISTINE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002000-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031931",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "06583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.