Active NPI
Astrid Diepenbroek, RDH LIMITED ACCESS
- Dental Hygienist
- North Bend, OR
National Provider Identifier
1518164201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H2672
- Practice address
- 1890 Waite St
Suite 1
North Bend, OR 97459-1229 - Phone
- (541) 756-6232
- Fax
- (541) 756-6234
- NPI assigned
- Jun 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H2672 | OR | Primary |
Addresses
Primary practice location
1890 Waite St
Suite 1
North Bend, OR 97459-1229
Mailing address
1890 Waite St
Suite 1
North Bend, OR 97459-1229
Phone (541) 756-6232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619915113 | Other | WATERFALL CLINIC - GROUP NPI |
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 |
|---|---|---|---|
| H2672 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228176000000",
"number": "1518164201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1890 WAITE ST",
"address_2": "SUITE 1",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974591229",
"telephone_number": "541-756-6232",
"fax_number": "541-756-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1890 WAITE ST",
"address_2": "SUITE 1",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974591229",
"telephone_number": "541-756-6232",
"fax_number": "541-756-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEPENBROEK",
"first_name": "ASTRID",
"credential": "RDH LIMITED ACCESS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-27",
"last_updated": "2008-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H2672",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WATERFALL CLINIC - GROUP NPI",
"identifier": "1619915113",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in North Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.