NPI age
1 years
Enumerated 2024-07-02
● Active Type 2 · Organization
Hayden Lake Family Dental Pllc
Hayden Lake Family Dental Pllc is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Davis
Member
Last NPPES update
2024-07-02
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
1 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-07Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
8636 N Wayne Dr
Hayden, ID 838355084
Mailing address
3010 E Fruitvale Ave
Gilbert, AZ 852975261
Authorized official
Chase Davis, DDS
Member
📞 4809178400
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Keira Greene, DDS Dentist NPI 1164626883
- Marie Smith Dentist NPI 1164976635
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.