Individual provider Active NPI

David Dierdorff, DC

  • Chiropractor
  • Spokane, WA
National Provider Identifier
1245933852
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61243647 Issued in WA
Practice address
501 S Bernard St Ste 300
Spokane, WA 99204-2511
Phone
(509) 316-0139
NPI assigned
Mar 23, 2023
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61243647 WA Primary

Addresses

Primary practice location

501 S Bernard St Ste 300
Spokane, WA 99204-2511

Mailing address

3611 N Normandie St
Spokane, WA 99205-3050
Phone (509) 951-9693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH61243647WAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1245933852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 N NORMANDIE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992053050",
            "telephone_number": "509-951-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BERNARD ST STE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042511",
            "telephone_number": "509-316-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERDORFF",
        "first_name": "DAVID",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61243647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.