DR. CHACE DERRICK MICKELSON D.M.D
NPI 1184035115
Dentist in Coeur D Alene, ID

Q: What is Chace Mickelson's NPI number?

The NPI number for Chace Mickelson is 1184035115. It was assigned to this individual provider in the NPPES registry on May 13, 2014.

Q: What is Chace Mickelson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Chace Mickelson was last updated on August 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 13, 2014

1090 W PARK PL, SUITE B, COEUR D ALENE, ID 83814(208) 292-0303 Get Directions Write a Review

NPPES record last updated: August 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Chace Derrick Mickelson D.m.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHACE DERRICK MICKELSON D.M.D (NPI 1184035115) is an individual dentist in Coeur D Alene, Idaho, licensed in Idaho (D-4605) and active in the NPI registry since May 2014.

NPPES Registry Identity

NPI1184035115

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. CHACE DERRICK MICKELSONCredential: D.M.D

Location Address1090 W PARK PL, SUITE BCoeur D Alene, ID 83814-2785

Mailing AddressPo Box 3648Coeur D'alene, ID 83816 · (208) 292-0292

Phone(208) 292-0303

Sole ProprietorNo

Enumeration DateMay 13, 2014

Last NPPES UpdateAugust 17, 2020

NPPES CertifiedAugust 17, 2020

✔ NPI 1184035115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in ID · D-4605✔ Licensed in TX · 29854

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1090 W PARK PL, Coeur D Alene, ID 83814

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

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