Active NPI
Dean Diffenbaugh
- Optician
- Fredericksburg, VA
National Provider Identifier
1548774425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- TBD
- Practice address
- 137 Spotsylvania Mall Ste 440a
Fredericksburg, VA 22407-1126 - Phone
- (540) 786-2272
- NPI assigned
- Nov 29, 2017
- Last updated
- Nov 29, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | TBD | VA | Primary |
Addresses
Primary practice location
137 Spotsylvania Mall Ste 440a
Fredericksburg, VA 22407-1126
Mailing address
137 Spotsylvania Mall Ste 440a
Fredericksburg, VA 22407-1126
Phone (540) 786-2272
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 |
|---|---|---|---|
| TBD | VA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511913600000",
"number": "1548774425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 SPOTSYLVANIA MALL STE 440A",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224071126",
"telephone_number": "540-786-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 SPOTSYLVANIA MALL STE 440A",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224071126",
"telephone_number": "540-786-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFFENBAUGH",
"first_name": "DEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-29",
"last_updated": "2017-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "VA",
"license": "TBD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.