Gregory M Dietz, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019027386 Issued in IL

Practice address

314 Susan Drive
Normal, IL 61761

Phone

(309) 827-5437

Fax

(309) 265-0288

NPI assigned

Feb 11, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Pediatric DentistryAlso: Dentist

Education

Southern Illinois Univ School of Dental Medicine, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Children'S Center for Dentistry PLLC

  • Pediatric Dentistry
  • Normal, IL
  • NPI 1285184259
  NPD Authorized official
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment
• Saint Francis Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment
• Children'S Center for Dentistry

  • Pediatric Dentistry
  • Normal, IL
  • NPI 1932709433
  NPD

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1386883593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 SUSAN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616206",
            "telephone_number": "309-827-5437",
            "fax_number": "309-265-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 SUSAN DRIVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-827-5437",
            "fax_number": "309-265-0288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-624-4012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "GREGORY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019027386",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marwan Dib, MD
• April L Dickenson, MD
• Jeffrey Lee Dickhut, D.C.
• Julie L Dieterman, RN, CNOR, RNFA
• Jay Martin Dietrich, APN, NP-C
• Renee Katherine Dietz, DMD
• Digestive Disease Consultants LTD
• Karissa Diller, LAT, ATC
• Thomas Diller, M.D.
• Lauren N Dinnsen

• Pediatric Dentistry in Normal, IL
• Providers in Normal, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.