Jennifer A Diederich, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

007122 Issued in CT

Practice address

222 Main St
PMB 251
Farmington, CT 06032-3623

Phone

(860) 751-9209

Fax

(860) 693-6309

NPI assigned

Oct 21, 2005

Last updated

Sep 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jennifer A Diederich Other name

Medicare fee-for-service enrollment

Enrolled in CT

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Compassion Dental 06032 LLC

  • Dental Clinic/Center
  • Farmington, CT
  • NPI 1225756125
  NPD Authorized official
• Compassion Dental 06032 LLC

  dba ComPassion Dental

  • Dental Clinic/Center
  • Farmington, CT
  • NPI 1417200932
  NPD Authorized official

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1356330344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "address_2": "#251",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323623",
            "telephone_number": "860-470-3660",
            "fax_number": "860-404-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "address_2": "PMB 251",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323623",
            "telephone_number": "860-751-9209",
            "fax_number": "860-693-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDERICH",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "007122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DIEDERICH",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anthony Diaz, MD
• Glorimar Rivera Diaz, FNP-BC
• Rubi R Diaz, APRN
• Alicia M Diclementi, OTR/L
• Kevin O Dieckhaus, MD
• Harrison Robert Dieuveuil, MD
• Mickayla Allen Diffley
• Erin Christine Dillman, LCSW
• Brendan Robert Dillon, MD
• Andrea J. Diluigi, MD

• General Practice Dentistry in Farmington, CT
• Providers in Farmington, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.