P Praxis·MD
● Active Type 1 · Individual

DR. Matthew David Nordlie, DMD

Dentist·Rathdrum, ID· NPI 1174178636 · Enumerated 2019 · 6 years on NPI
Nordlie is 1 of 4 dentist providers in Rathdrum and 1 of 1099 in Idaho.
NPI age
6 years
Enumerated 2019-08-01
Primary specialty
Dentist
Licensed in
WA
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-08-04
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 1099 active dentist providers in Idaho.

NPI age
6 years
↓ 12 yr below median (18 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
12% of peers hold subspecialties

NPI lifetime · 2019 → 2026

2019-08Enumerated in NPPES
2019 2026

Where they practice

Practice location
3170 W MacK Ln
Rathdrum, ID 838584500
📞 2532493581
Mailing address
21421 Snag Island Dr E
Lake Tapps, WA 983918709

Specialties

  • Dentist Primary
    A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
    WA license #DE60966868 taxonomy 1223G0001X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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