Amy Lee Dibello

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH60658592 Issued in WA

Practice address

314 S Ennis St
Port Angeles, WA 98362-4716

Phone

(360) 565-6128

NPI assigned

Jun 19, 2018

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1508350893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 S ENNIS ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624716",
            "telephone_number": "360-565-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S ENNIS ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624716",
            "telephone_number": "360-565-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBELLO",
        "first_name": "AMY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH60658592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HYGIENIST",
            "identifier": "DH60658592",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DH60658592",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Dewey-Osborne, LPN
• Patrick Dewitt, COTA
• Darcy Deyling, LMHC-A
• Ellen Dezellem
• Jessica A Dibari, D.O.
• Dirk a. Gouge, D.O.
• Ianir Divinsky, MD
• Miklo Jashua Dixon, BHT,CNA
• Dixons Recovery Ranch Outreach
• Jaymes Allison Doane, CDP

• Dental Hygienist in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.