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

Daniel John Stackowicz, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1740605104

Daniel John Stackowicz, DDS is a Student in an Organized Health Care Education/Training Program in Boise, Idaho. Works from 2 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2014
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1410 S Entertainment Ave
Boise, ID 83709-8306
Phone: (208) 321-4937
Fax: (208) 321-4834
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7500 Cambridge St, Houston, TX 77054-2032 — (713) 586-4052

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D5162 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1740605104
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedFebruary 21, 2014
Last updated in NPPESDecember 11, 2020
Certification dateDecember 11, 2020
Mailing address1410 S Entertainment Ave, Boise, ID 83709-8306

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