Coeur D'Alene Denture Clinic LLC

Primary specialty

DenturistTaxonomy code 122400000X

Legal business name

COEUR D'ALENE DENTURE CLINIC LLC

Practice address

1119 N 4TH St
Coeur D Alene, ID 83814-3216

Phone

(208) 667-8997

NPI assigned

Aug 19, 2026

Last updated

Aug 19, 2026By 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

Sausha MannonNPI 1962324855

Title

Clinical Owner

Phone

(208) 930-9464

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Sausha Mannon, DENTURIST

  • Denturist
  • Coeur d'Alene, ID
  • NPI 1962324855
  Authorized official Same address or phone

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1972419240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143216",
            "telephone_number": "208-667-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143216",
            "telephone_number": "208-667-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COEUR D'ALENE DENTURE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "MANNON",
        "authorized_official_first_name": "SAUSHA",
        "authorized_official_title_or_position": "CLINICAL OWNER",
        "authorized_official_telephone_number": "208-930-9464"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coeur D Alene Primary Care PLLC
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• Coeur D Mind
• Coeur D' Alene Foot & Ankle Clinic LLC
• Coeur D' Alene Oral Surgery
• Coeur D'Alene OB/GYN, PA
• Coeur D'Alene Partners, LLC Dba Creekside Inn Assisted Living Alz Comm
• Coeur D'Alene Pediatrics PA
• Coeur D'Alene School District #271
• Coeur D'Alene Surgery Center Inc

• Denturist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Denturist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.

Verify at the official NPI Registry.