Charles Dietrich, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN 3288 Issued in DC

Practice address

5028 Wisconsin Ave NW
Suite 102
Washington, DC 20016-4118

Phone

(202) 363-6177

NPI assigned

May 30, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1243641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243641600000",
    "number": "1609002088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 WISCONSIN AVE NW",
            "address_2": "SUITE 102",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5028 WISCONSIN AVE NW",
            "address_2": "SUITE 102",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164118",
            "telephone_number": "202-363-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "CHARLES",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-30",
        "last_updated": "2009-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN 3288",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "6399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Keough Diebold, PT, DPT
• David Joseph Diemert, MD
• Jillian Diesner, ED.S., LPC
• Alexis Anne Dieter, M.D.
• Emily Glass Dietle, M.D.
• Celestine Dieupa Epse Kouamen
• Faty Dieye, DPM
• Claudia Ann Diffenbaugh
• Josiane Diffokou
• Patricia Diggs-Shabazz

• General Practice Dentistry in Washington, DC
• Providers in Washington, DC by specialty
• General Practice Dentistry in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2009; 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.