Amanda Lynn Delwiche, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51915 Issued in CA

Practice address

2801 Yulupa Ave
Suite D
Santa Rosa, CA 95405-9115

Phone

(707) 526-6165

Fax

(707) 526-6238

NPI assigned

Apr 14, 2008

Sex

Female

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 31, 2017 through May 31, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1316111081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 YULUPA AVE",
            "address_2": "SUITE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954059115",
            "telephone_number": "707-526-6165",
            "fax_number": "707-526-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 YULUPA AVE",
            "address_2": "SUITE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954059115",
            "telephone_number": "707-526-6165",
            "fax_number": "707-526-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELWICHE",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Marie Dellinger
• Anne Delmonte, M.F.C.C. LIC # 25427
• Zachary Santiago Delpier
• Katherine Jeanne Delse
• Leah Deluca, PT, DPT
• Steve Demaderios, PT, PEMF
• Sara Demedeiros, RRT
• Aldona May Dement
• Mark Demeo, MD
• Charles Geoffrey Demitz, MD

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.