Diterlizzi Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DITERLIZZI DENTAL, LLC

Practice address

1359 S Holland Sylvania Rd
Holland, OH 43528-8423

Phone

(419) 865-4441

NPI assigned

Jun 6, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jason Derrick Diterlizzi, DDS

Title

Dentist

Phone

(419) 340-2054

Specialties & licenses 1

Addresses

Other names 1

• Spring Valley Dental Doing business as

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1770142564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 S HOLLAND SYLVANIA RD",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288423",
            "telephone_number": "419-865-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 S HOLLAND SYLVANIA RD",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288423",
            "telephone_number": "419-865-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DITERLIZZI DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "DITERLIZZI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "DERRICK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "419-340-2054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Charles Decker
• Lisa Delas
• Teresa Nickole Dennis
• Qiana Depp, AESTHETICIAN
• Ciara Latavia Dickerson
• Vy T DO, LISW-S
• Randall Ryan Domby
• Erich Donati, CDCA
• Mairead Elizabeth Donovan
• Clint Dorn

• Dental Clinic/Center in Holland, OH
• Providers in Holland, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.