DAN STREEBY D.D.S. NPI 1861015653

NPI Information

  • NPI: 1861015653
  • Provider Name: DAN STREEBY, D.D.S.
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 450 W STATE ST STE 180
    EAGLE, ID
    ZIP 83616
  • Phone: (208) 939-0600

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NPI Details

DAN STREEBY, D.D.S. is a pediatric dentistry dentist in Eagle, ID. The provider is 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. DAN STREEBY, D.D.S. NPI is 1861015653. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

450 W STATE ST STE 180
EAGLE, ID
ZIP 83616-974
Phone: (208) 939-0600
Fax: (208) 939-0774

The provider's authorized official is Dan Robert Streeby .
The authorized official title is Owner and has the following contact phone number (208) 939-0600.

The enumeration date for this NPI number is 5/27/2020 and was last updated on 5/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric DentistryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
128911MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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