Leeann Diercks, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D1113 Issued in SD

Practice address

20 19TH St SE
Watertown, SD 57201-3938

Phone

(605) 886-2805

NPI assigned

May 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1174934574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 19TH ST SE",
            "address_2": "PO BOX 330",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-886-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 19TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-886-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERCKS",
        "first_name": "LEEANN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D1113",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William W Devine, MD
• Amanda R Devries, LPC
• Diagnostic Radiology Associates LLC
• Edward A Dickes, M.D.
• Jessica Dickes, M.D.
• Bryan Garry Dingsor, DC
• Debora K Dockter, O.T.
• Darla J. Doop Huffman, LPC-MH
• Dr Casey D. Johnston MD PC
• Dr. Kevin B Hericks DDS PC

• Dentist in Watertown, SD
• Providers in Watertown, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.