Denise Dilts-Waldrop

Primary specialty

OpticianTaxonomy code 156FX1800X

License

SL5482 Issued in CA

Practice address

4626 Shasta Dam Blvd
Shasta Lake, CA 96019-9414

Phone

(530) 275-0866

Fax

(530) 275-8596

NPI assigned

Jul 6, 2017

Last updated

Jul 21, 2022By 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

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851812267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 SHASTA DAM BLVD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199414",
            "telephone_number": "530-275-0866",
            "fax_number": "530-275-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 SHASTA DAM BLVD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199414",
            "telephone_number": "530-275-0866",
            "fax_number": "530-275-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILTS-WALDROP",
        "first_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "SL5482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Anne Corpuz, PHARM D
• Lisa Marie Corral
• Francine Suzanne Cullivan
• Stephen Davids
• Peggy Jane Deforest, P.A.
• Lisa Marie Dinubilo, PHARM. D
• James G Earle, M.P.T., C.S.C.S.
• Samantha Enzler
• Darrin Ferguson, RN
• Rebecca Ann Fisher, LCSW

• Optician in Shasta Lake, CA
• Providers in Shasta Lake, CA by specialty
• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.