Active NPI
Joseph Dietrich, D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Alliance, OH
National Provider Identifier
1467694505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 30-023321
- Practice address
- 1455 S Sawburg Ave
Alliance, OH 44601-3521 - Phone
- (330) 821-4187
- Fax
- (330) 821-4641
- NPI assigned
- Apr 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 30-023321 | OH | Primary |
Addresses
Primary practice location
1455 S Sawburg Ave
Alliance, OH 44601-3521
Mailing address
1455 S Sawburg Ave
Alliance, OH 44601-3521
Phone (330) 821-4187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-023321 | OH | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph S Dietrich DMD LLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Dietrich Orthodontics
- Orthodontics and Dentofacial Orthopedics Dentistry
- Canton, OH
- NPI 1588346985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1467694505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1455 S SAWBURG AVE",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "446013521",
"telephone_number": "330-821-4187",
"fax_number": "330-821-4641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 S SAWBURG AVE",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "446013521",
"telephone_number": "330-821-4187",
"fax_number": "330-821-4641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICH",
"first_name": "JOSEPH",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-06",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "OH",
"license": "30-023321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alliance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.