Active NPI
Dan L Watt, DDS
- General Practice Dentistry
- Melba, ID
National Provider Identifier
1740239185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D3857
- Practice address
- 150 2ND Avenue
Melba, ID 83641 - Phone
- (208) 495-1011
- Fax
- (208) 495-1012
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D3857 | ID | Primary |
Addresses
Primary practice location
150 2ND Avenue
Melba, ID 83641
Mailing address
PO Box 9
211 16TH Avenue North
Nampa, ID 83653-0009
Phone (208) 467-4431
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CS10865 | Other | ID | CONTROLLED SUBSTANCE REGI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D3857 | ID | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1740239185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9",
"address_2": "211 16TH AVENUE NORTH",
"city": "NAMPA",
"state": "ID",
"postal_code": "836530009",
"telephone_number": "208-467-4431",
"fax_number": "208-467-7684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 2ND AVENUE",
"city": "MELBA",
"state": "ID",
"postal_code": "83641",
"telephone_number": "208-495-1011",
"fax_number": "208-495-1012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATT",
"first_name": "DAN",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D3857",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTROLLED SUBSTANCE REGI",
"identifier": "CS10865",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melba, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.