Dan Streeby, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DAN STREEBY, D.D.S.

Practice address

450 W State St Ste 180
Eagle, ID 83616-6974

Phone

(208) 939-0600

Fax

(208) 939-0774

NPI assigned

May 27, 2020

Last updated

May 27, 2020By 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. Dan Robert Streeby, DDSNPI 1396795068

Title

Owner

Phone

(208) 939-0600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Dan Streeby, DDS

  • Pediatric Dentistry
  • Eagle, ID
  • NPI 1396795068
  NPD Authorized official
• Colton Charles, DMD

  • General Practice Dentistry
  • Eagle, ID
  • NPI 1073826772
  NPD

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1861015653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 180",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "208-939-0600",
            "fax_number": "208-939-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 180",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "208-939-0600",
            "fax_number": "208-939-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN STREEBY, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "STREEBY",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-939-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28911",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Customedica Pharmacy Inc
• Rebekah Dianne Cutler, PA
• CWCD, P.C. (Cottonwood Creek Dental)
• Alexas Dahl
• Joseph Gordon Daines, M.D.
• Cameron Daron
• Natasha Davey
• Edward D Davila, MD
• Greg Ron Davis, D.D.S
• Dawn Soriano PLLC (Dawn Soriano LCSW)

• Pediatric Dentistry in Eagle, ID
• Providers in Eagle, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.