NPIMap

Organization Active NPI

RSS Michael Dierkes LLC

  • Dentist
  • Atlanta, GA
National Provider Identifier
1720595994
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN009675 Issued in GA
Legal business name
RSS MICHAEL DIERKES LLC
Practice address
4920 Roswell Rd Ste 255
Atlanta, GA 30342-2686
Phone
(844) 859-2525
NPI assigned
Jan 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

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

Authorized official

Name
Michael Dierkes
Title
Owner
Phone
(817) 405-7470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN009675 GA Primary

Addresses

Primary practice location

4920 Roswell Rd Ste 255
Atlanta, GA 30342-2686

Mailing address

1050 Texan TRL Ste 300
Grapevine, TX 76051-3759

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548547200000",
    "number": "1720595994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 TEXAN TRL STE 300",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 ROSWELL RD STE 255",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422686",
            "telephone_number": "844-859-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSS MICHAEL DIERKES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2019-01-27",
        "status": "A",
        "authorized_official_last_name": "DIERKES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-405-7470"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN009675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; 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.