Diane Margaret Metrick, DDS
Individual provider Active NPI Dentist · Wheaton, IL
NPI 1992816433 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992816433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 319 E Roosevelt Rd
Wheaton, IL 60187-5526 - Phone
- (630) 665-5555
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-021221 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amber Dental PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
319 E Roosevelt Rd
Wheaton, IL 60187-5526
Mailing address
319 E Roosevelt Rd
Wheaton, IL 60187-5526
Phone (630) 665-5555
Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.