Active NPI
Michael Diep, DDS
- General Practice Dentistry
- Walnut, CA
National Provider Identifier
1952490104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 51573
- Practice address
- 330 N Lemon Ave
Walnut, CA 91789-2338 - Phone
- (909) 594-9444
- NPI assigned
- Oct 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 51573 | CA | Primary |
Addresses
Primary practice location
330 N Lemon Ave
Walnut, CA 91789-2338
Mailing address
330 N Lemon Ave
Walnut, CA 91789-2338
Phone (909) 594-9444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51573 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MD Dental Corp | Current | Accepting new patients | |
| Sahawaneh Dental Corporaton | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952490104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N LEMON AVE",
"city": "WALNUT",
"state": "CA",
"postal_code": "917892338",
"telephone_number": "909-594-9444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N LEMON AVE",
"city": "WALNUT",
"state": "CA",
"postal_code": "917892338",
"telephone_number": "909-594-9444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEP",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "51573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.