Dustin Patrick Deryke, D.C.
Individual provider Active NPI Chiropractor · Carpinteria, CA
NPI 1265746267 · NPPES record last updated Aug 2, 2010
Key facts
- NPI
- 1265746267
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 31497 (CA)
- Practice address
- 1101 Bailard Ave
Carpinteria, CA 93013-2637 - Phone
- (805) 636-8652
- NPI assigned
- Aug 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31497 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 31497 | CA | Yes |
Addresses
Primary practice location
1101 Bailard Ave
Carpinteria, CA 93013-2637
Mailing address
1101 Bailard Ave
Carpinteria, CA 93013-2637
Phone (805) 636-8652
Other providers in Carpinteria, CA
- Belva Crocker
- Melanie Crowther
- Kathleen M Cummings
- Lenita Anne Davison
- Karen De Vera
- Ronald A Desandre
- Linda Dezeeuw
- Arielle Dittman-Sompel
- Carolyn Ann Dobson
- Mary Doiron
All providers in Carpinteria, CA · Chiropractor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.