Chase A Funk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4582ID Issued in ID

Practice address

1415 Fillmore St Ste 701
Twin Falls, ID 83301-3346

Phone

(208) 735-1415

Fax

(208) 734-7603

NPI assigned

Jun 17, 2014

Last updated

Feb 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mint Dental Care PLLC

  dba Mint Dental Care

  • General Practice Dentistry
  • Twin Falls, ID
  • NPI 1245064427
  NPD Authorized official
• Kevin L Hamblin DDS

  • Dentist
  • Twin Falls, ID
  • NPI 1760599963
  NPD (past)
• Sawtooth Dental PLLC

  • General Practice Dentistry
  • Twin Falls, ID
  • NPI 1164539383
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1962816025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 FILLMORE ST STE 701",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013346",
            "telephone_number": "208-735-1415",
            "fax_number": "208-733-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 FILLMORE ST STE 701",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013346",
            "telephone_number": "208-735-1415",
            "fax_number": "208-734-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "CHASE",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4582",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4582ID",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward L Fuchs
• Brooke Marie-Osgood Fukuoka
• Chuck B Fuller, PA-C
• Jennie Rebecca Fullmer, LPC
• Shawna Fultz, LMSW
• Spencer Funk, DO
• G Adrian Dean MD Inc
• Anurag Gaddam, MD
• Cecil Gailey
• Mildred Azucena Gaitan-Gonzalez, L.C.S.W.

• General Practice Dentistry in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.

Verify at the official NPI Registry.