Dallin J. Dance, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D-4693-PD Issued in ID

Practice address

1027 W. Prairie Ave.
Hayden, ID 83835

Phone

(208) 772-2202

Fax

(208) 772-2213

NPI assigned

Jul 28, 2014

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 21, 2022 through Feb 21, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ddance627505@direct.multicare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dance Dentistry PLLC

  • General Practice Dentistry
  • Hayden, ID
  • NPI 1548637994
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1982012498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 N. BERGSON DR.",
            "city": "COEURD'ALENE",
            "state": "ID",
            "postal_code": "83815",
            "telephone_number": "425-241-7554",
            "fax_number": "208-772-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 W. PRAIRIE AVE.",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-772-2202",
            "fax_number": "208-772-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCE",
        "first_name": "DALLIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "90790579922",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D-4693-PD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arrian E Culjak, RN, NP-C
• Cunningham Chiropractic, P.C.
• Wendy Nagy Cunningham, D.C.
• Tanya Currie
• Dance Dentistry PLLC
• Thomas Matthew Dance, DDS
• Shawna Lynn Daniels, RPH
• Jordan Camille Dansereau, RDN, IBCLC
• Carrie Ann Day
• Dayspring Midwifery Services

• All providers in Hayden, ID
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.