Douglas Norman Dederich, DDS, PHD
Periodontics · Glendale, WI
Practice location
500 W Silver Spring Dr Ste K250Glendale, WI 53217-5062
- Phone
- (414) 963-2301
NPI record
- NPI
- 1932949203
- Entity type
- Individual (Type 1)
- Enumeration date
- May 25, 2024
- Last updated
- May 25, 2024
- Certified
- May 25, 2024
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Periodontics Primary | 1223P0300X |
3322-15 | WI |
Mailing address
6330 W Greenfield Ave Apt 408Milwaukee, WI 53214-5073
- Phone
- (780) 868-1562
About Dr. Dederich
Douglas Norman Dederich, DDS, PHD is a healthcare provider registered in the NPI registry with the primary taxonomy Periodontics (code 1223P0300X). The practice location is 500 W Silver Spring Dr Ste K250, Glendale, WI 53217-5062. The NPI number 1932949203 was assigned on May 25, 2024 and the record was last updated on May 25, 2024.
Dr. Dederich lists a license in the registry: #3322-15 (WI) for Periodontics. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Douglas Norman Dederich, DDS, PHD?
The NPI number is 1932949203.
What is the phone number of Dr. Dederich?
The phone number listed for the practice location is (414) 963-2301.
Where is Dr. Dederich located?
500 W Silver Spring Dr Ste K250, Glendale, WI 53217-5062.
What is the taxonomy code for Dr. Dederich?
The primary taxonomy code is 1223P0300X – Periodontics.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.