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General NPI Number Information
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NPI Number | 1215517990
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Entity Type | Individual
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Provider Name | TANA DAHL D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 440 SCIENCE DR STE 300
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City | MADISON
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State | WI
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Zip | 53711-1064
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Country | US
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Telephone | 262-999-3495
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 262-999-3495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 77955-21
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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