Blair Dieterlen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8027 Issued in OK

Practice address

3015 E 91St St
Tulsa, OK 74137-3324

Phone

(918) 299-2400

NPI assigned

Oct 15, 2025

Last updated

Oct 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brett B. Dieterlen D.D.S., P.C.

  • Preferred Provider Organization
  • Tulsa, OK
  • NPI 1669648721
  NPD (past)

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1710853825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E 91ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373324",
            "telephone_number": "918-299-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E 91ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373324",
            "telephone_number": "918-299-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETERLEN",
        "first_name": "BLAIR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "8027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumner Anne Dieck
• Krysta Michelle Diehl-Craig, LPC
• Brian Craig Diener, DO
• Harrison Diep
• Tuana Dinh Diep, MD
• Brett Buchanan Dieterlen, D.D.S.,B.S.
• Grant Michael Dietz, PA-C
• Lisa Diane Dietz, M.S.
• Melissa Ann Dietz, M.D.
• Sandra Renee Dietz, APRN-CNP

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.