David M Diehl, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010145A Issued in IN

Practice address

10215 Dupont Circle Dr W
Fort Wayne, IN 46825-1656

Phone

(260) 489-1100

Fax

(260) 489-1800

NPI assigned

Nov 28, 2006

Sex

Male

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Dupont Family Dentistry, P.C.

  • Dentist
  • Fort Wayne, IN
  • NPI 1255767596
  NPD Authorized official

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1821164906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 DUPONT CIRCLE DR W",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251656",
            "telephone_number": "260-489-1100",
            "fax_number": "260-489-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 DUPONT CIRCLE DR W",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251656",
            "telephone_number": "260-489-1100",
            "fax_number": "260-489-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010145A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Didier, MS, LMFT
• Susan E Didion, RN
• Ryan Diederich
• Martin Joseph Diedrich, COTA
• Jill M Diedring, NP
• Melody Diehm
• Seagan Kay Diehm
• Kathryn Rudolph Diekhoff, NP
• Ryan M. Diepenbrock, D.D.S.
• Karla Kay Dierlam

• All providers in Fort Wayne, IN
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.