NPIMap

Organization Active NPI

Jeremy H Diehl, D.D.S., M.S.D., PC

  • Periodontics
  • Vancouver, WA
National Provider Identifier
1346478906
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE60083669 Issued in WA
Legal business name
JEREMY H DIEHL, D.D.S., M.S.D., PC
Practice address
2702 NE 78TH St
Suite 108
Vancouver, WA 98665-0665
Phone
(360) 693-1200
Fax
(360) 693-2001
NPI assigned
Jun 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Dr. Jeremy H Diehl, D.D.S., M.S.D.NPI 1023248291
Title
President
Phone
(360) 693-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DE60083669 WA Primary

Addresses

Primary practice location

2702 NE 78TH St
Suite 108
Vancouver, WA 98665-0665

Mailing address

2702 NE 78TH St
Suite 108
Vancouver, WA 98665-0665
Phone (360) 693-1200

National Provider Directory

National Provider Directory

Locations

2702 NE 78th St
Ste 108
Vancouver, WA 98665
Phone (360) 693-1200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1346478906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NE 78TH ST",
            "address_2": "SUITE 108",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650665",
            "telephone_number": "360-693-1200",
            "fax_number": "360-693-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 NE 78TH ST",
            "address_2": "SUITE 108",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650665",
            "telephone_number": "360-693-1200",
            "fax_number": "360-693-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY H DIEHL, D.D.S., M.S.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "DIEHL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-693-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60083669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.