Renee Katherine Dietz, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08810 Issued in IA

Practice address

314 Susan Drive
Normal, IL 61761

Phone

(309) 827-5437

Fax

(309) 265-9288

NPI assigned

Dec 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Center for Dentistry

  • Pediatric Dentistry
  • Normal, IL
  • NPI 1932709433
  NPD
• Children's Center for Dentistry PLLC

  • Pediatric Dentistry
  • Normal, IL
  • NPI 1285184259

  General Practice

  NPD
• Tazewell County Health Department -Dental Health Center

  • Public Health or Welfare Agency
  • North Pekin, IL
  • NPI 1649308230
  NPD (past)
• Gentle Dental, P.C.

  • General Practice Dentistry
  • Cedar Rapids, IA
  • NPI 1518166693
  NPD (past)

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1821272030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 SUSAN DRIVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-827-5437",
            "fax_number": "309-265-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 SUSAN DRIVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-827-5437",
            "fax_number": "309-265-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "RENEE",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027385",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "08810",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April L Dickenson, MD
• Jeffrey Lee Dickhut, D.C.
• Julie L Dieterman, RN, CNOR, RNFA
• Jay Martin Dietrich, APN, NP-C
• Gregory M Dietz, D.M.D.
• Digestive Disease Consultants LTD
• Karissa Diller, LAT, ATC
• Thomas Diller, M.D.
• Lauren N Dinnsen
• Abbey Joelle Disalvo

• General Practice Dentistry in Normal, IL
• Providers in Normal, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.