Patricio Rafael Dibble, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2086 Issued in ND

Practice address

515 20TH Ave SE
Suite 8
Minot, ND 58701-6661

Phone

(701) 852-4755

NPI assigned

Dec 15, 2009

Last updated

Sep 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pat and Amanda Dibble PLLC

  dba Dibble Family Dental

  • Dentist
  • Federal Way, WA
  • NPI 1447600507
  NPD (past) Authorized official
• Dakota Dental Health Center

  • General Practice Dentistry
  • Minot, ND
  • NPI 1619185824
  NPD (past)
• Dakota Dental Health Center PLLC

  • General Practice Dentistry
  • Minot, ND
  • NPI 1639414451
  NPD (past)

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1306175625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 20TH AVE SE",
            "address_2": "SUITE 8",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016661",
            "telephone_number": "701-852-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 20TH AVE SE",
            "address_2": "SUITE 8",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016661",
            "telephone_number": "701-852-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "PATRICIO",
        "middle_name": "RAFAEL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-15",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree A Desjardins, FNP
• Norma J Desjarlais
• Darla F Deslauriers, LAC
• Peter P. Dettlaff, O.D.
• Joat Dhaliwal, MD
• Heather Dibra, MHS OTR/L
• Minda Dickens
• Analycia Dickerson, LMSW
• Kelly Courtney Dickinson, FNP-C
• Pavlin Emilov Dimitrov, PHARMD

• General Practice Dentistry in Minot, ND
• Providers in Minot, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.