Bruce L Dahl, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3903 Issued in ND

Practice address

1220 Sheyenne St
West Fargo, ND 58078-2637

Phone

(701) 234-4446

Fax

(701) 234-4455

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1801814546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782637",
            "telephone_number": "701-234-4446",
            "fax_number": "701-234-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782637",
            "telephone_number": "701-234-4446",
            "fax_number": "701-234-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "BRUCE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "3903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13239",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Crossover Health Medical Group
• Curavita LLC
• Jennifer Dahl
• Dakota Clinic, LTD.
• Sydney Dale
• Jon D Dangerfield, MD
• Daniel & Max, LLC

• Family Medicine Physician in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Family Medicine Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.