Anna Dierking, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

12 Long Lake Rd Ste 12
Saint Paul, MN 55115-1200

Phone

(651) 770-2699

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Community Dental Care Inc

  • General Practice Dentistry
  • Buffalo, MN
  • NPI 1275280810
  NPD
• Orchard Dental Group, P.L.L.C.

  • Dentist
  • Mahtomedi, MN
  • NPI 1932335098
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1215501754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LONG LAKE RD STE 12",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151200",
            "telephone_number": "651-770-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LONG LAKE RD STE 12",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551151200",
            "telephone_number": "651-770-2699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Beam Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091227",
            "country_code": "US",
            "telephone_number": "651-925-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIERKING",
        "first_name": "ANNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Dickson, MD
• Justin Crawford Diehl, LADC
• Joseph Diehn
• Benita S Dieperink, MD
• Connie I Diercks, CNM
• Dianna Lynn Diers, MA LAMFT
• Elizabeth Dietz, MD
• James Bradley Dietz, D.C.
• Michelle Marie Diffenbaugh, LADC
• Jack Difino

• All providers in Saint Paul, MN
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.