NPIMap

Organization Active NPI

David Dibble DDS PC

  • Dentist
  • Central Lake, MI
National Provider Identifier
1508958273
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901013248 Issued in MI
Legal business name
DAVID DIBBLE DDS PC
Practice address
2550 N Main Street
Central Lake, MI 49622
Phone
(231) 544-8115
Fax
(231) 544-6012
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Lee Dibble, DDSNPI 1184720856
Title
President
Phone
(231) 544-8115

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2901013248 MI Primary

Addresses

Primary practice location

2550 N Main Street
Central Lake, MI 49622

Mailing address

PO Box 457
2550 N Main Street
Central Lake, MI 49622
Phone (231) 544-8115

National Provider Directory

National Provider Directory

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508958273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "address_2": "2550 N MAIN STREET",
            "city": "CENTRAL LAKE",
            "state": "MI",
            "postal_code": "49622",
            "telephone_number": "231-544-8115",
            "fax_number": "231-544-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 N MAIN STREET",
            "city": "CENTRAL LAKE",
            "state": "MI",
            "postal_code": "49622",
            "telephone_number": "231-544-8115",
            "fax_number": "231-544-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID DIBBLE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIBBLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-544-8115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.