Jeremy Howard Diehl, D.D.S., M.S.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DE60083669 Issued in WA

Practice address

2702 NE 78TH St
Suite 108
Vancouver, WA 98665-0665

Phone

(360) 693-1200

Fax

(360) 693-2001

NPI assigned

Jul 21, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jeremy H Diehl, D.D.S., M.S.D., PC

  • Periodontics
  • Vancouver, WA
  • NPI 1346478906
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1023248291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NE 78TH ST",
            "address_2": "SUITE 108",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650665",
            "telephone_number": "360-693-1200",
            "fax_number": "360-693-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 NE 78TH ST",
            "address_2": "SUITE 108",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650665",
            "telephone_number": "360-693-1200",
            "fax_number": "360-693-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "JEREMY",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60083669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFICATION NUMBER TYPE 2",
            "identifier": "1346478906",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Dickman, BS
• Danielle Allison Dickson
• Erica N Dickson, AGACNP
• Lana Dickson
• Ivan Y Didyk, RN
• Diep Pham PC
• Jacqueline Kay Diercks
• Adrienne Diers
• Toni Jo Dietel, R.D.H.
• Patrick L Dieter, CDP

• Periodontics in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Periodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.