Dan Streeby is a Pediatric Dentistry in Eagle, Idaho. Dan Streeby practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Dan Streeby is 1396795068. The last update date is 2008-01-02.
Dan Streeby's current location address is 450 W State St, Eagle, Idaho. You can contact this provider via phone number 2089390600 and fax number 2089390774. The mailing address for Dan Streeby is 450 W State St, Eagle, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dan Streeby |
|---|---|
| Address | 450 W State St, Eagle, Idaho |
| Phone Number | 2089390600 |
| Fax Number | 2089390774 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1396795068 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2008-01-02 |
Provider Mailing Address Detail
| Address | 450 W State St |
|---|---|
| City | Eagle |
| State | Idaho (ID) |
| Post Code | 836166974 |
| Phone Number | 2089390600 |
| Fax Number | 2089390774 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | D3301PD |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| D3301PD | ID | STATE LICENSE # |
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What is the unique 10-digit identifier code issued to Dan Streeby by the Centers for Medicare & Medicaid Services?
The Dan Streeby has been assigned the NPI (National Provider Identifier) 1396795068 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Dan Streeby's physical address?
The Dan Streeby is physically located at 450 W State St, in the city of Eagle, ID, with the postal code 836166974.
What is Dan Streeby's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Dan Streeby is Pediatric Dentistry, and the taxonomy code that categorizes this field of expertise is 1223P0221X.
On what date did the Dan Streeby receive the assignment of its 1396795068 from the Centers for Medicare & Medicaid Services?
The Dan Streeby was issued its 1396795068 by the Centers for Medicare & Medicaid Services on 2006-05-11.
When was the information pertaining to Dan Streeby most recently updated or revised?
The details related to Dan Streeby, including its address, specialty, and other relevant information, were last updated or revised on 2008-01-02.