Diehl Periodontics PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

DIEHL PERIODONTICS PLLC

Doing business as

Periodontics & Dental Implants of Central Park

Practice address

2979 Iola St
Denver, CO 80238-3193

Phone

(720) 703-9116

NPI assigned

Jan 14, 2025

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyler Dylan Sutton

Title

Office Manager

Phone

(720) 703-9116

Specialties & licenses 1

Addresses

Other names 1

• Periodontics & Dental Implants of Central Park Doing business as

Locations

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1023829678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 IOLA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383193",
            "telephone_number": "720-703-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 IOLA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383193",
            "telephone_number": "720-703-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIEHL PERIODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "720-703-9116"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Periodontics & Dental Implants of Central Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Periodontics & Dental Implants of Central Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lattrice Dickson, RN
• Nikki Jo Dickson, PHYSICIAN ASSISTANT
• Lara Marie Dicus, LCSW
• Melody Ann Didisse, M.A., LMFT
• Kimberly Didsbury, DPT
• Evan Diehl
• Kyle Diehl, PH.D., DDS
• McKenzie Dieken
• Angel Diele Wood, LPC, LAC
• Sarah L Diemert, WHNP

• Periodontics in Denver, CO
• Providers in Denver, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.