Adam J Diesburg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9125 Issued in OR

Practice address

1927 NE Baker St
McMinnville, OR 97128-2601

Phone

(503) 472-2222

NPI assigned

Dec 3, 2008

Last updated

Jan 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325462400000",
    "number": "1528203601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 NE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971282601",
            "telephone_number": "503-472-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 NE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971282601",
            "telephone_number": "503-472-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIESBURG",
        "first_name": "ADAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-03",
        "last_updated": "2012-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert John Demaster, MD
• Dental Professionals of Oregon, P.C. (V2 Family & Cosmetic Dentistry)
• Samantha Dewey
• Virginia M Deyerle
• Keith Alexander Dickson, ND
• Sharon Dieter, PPS
• Sam Wei Dieu, APRN, RN
• Lovetta Annette Dill
• Lisa Marie Dillman, MA, QMHP, CADC I
• Walter Dillman

• General Practice Dentistry in McMinnville, OR
• Providers in McMinnville, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.