Active NPI
Christine L Dahl, DDS
- Dentist
- Bettendorf, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 06583
- Practice address
- 25185 Valley Dr
Bettendorf, IA 52722-7319 - Phone
- (563) 505-1350
- NPI assigned
- Jul 30, 2008
- Last updated
- Sep 25, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06583 | IA | MD | Dentist |
| 019.031931 | IL | MD | Dentist |
| 1002000-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoples Community Health Clinic, Inc. | Single Specialty | Current | Accepting new patients |
| Peoples Community Health Clinic, Inc | Current | 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
- 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.
-
dba Success Street-West High School
- Federally Qualified Health Center (FQHC)
- Waterloo, IA
- NPI 1629684709
Single Specialty
-
- General Practice Dentistry
- Bettendorf, IA
- NPI 1013044684
-
dba Peoples Clinic Clarksville School
- Federally Qualified Health Center (FQHC)
- Clarksville, IA
- NPI 1336850734
-
- Federally Qualified Health Center (FQHC)
- Waterloo, IA
- NPI 1093703639
Single Specialty
-
dba Bettendorf Dental
- General Practice Dentistry
- Bettendorf, IA
- NPI 1154880771
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.