Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Hayden Lake Family Dental PLLC

Organization Dental Clinic/Center · NPI 1942046651

Hayden Lake Family Dental PLLC is a Dental Clinic/Center in Hayden, Idaho. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8636 N Wayne Dr
Hayden, ID 83835-5084
Phone: (208) 762-1555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1942046651
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chase Davis — Member · (480) 917-8400
NPI enumeratedJuly 2, 2024
Last updated in NPPESJuly 2, 2024
Certification dateJuly 2, 2024
Mailing address3010 E Fruitvale Ave, Gilbert, AZ 85297-5261

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