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DALLAS EDWARD DUDELSTON
NPI 1508739103
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since September 29, 2025
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134(765) 209-0919 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dallas Edward Dudelston NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DALLAS EDWARD DUDELSTON (NPI 1508739103) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since September 2025.

NPPES Registry Identity

NPI1508739103
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameDALLAS EDWARD DUDELSTON
Location Address34101 FARENHOLT AVE BLDG 14San Diego, CA 92134-7000
Mailing Address34101 Farenholt Ave Bldg 14San Diego, CA 92134-7000
Phone(765) 209-0919
Sole ProprietorNo
Enumeration DateSeptember 29, 2025
NPPES CertifiedSeptember 29, 2025
✔ NPI 1508739103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
34101 FARENHOLT AVE BLDG 14, San Diego, CA 92134
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICHAEL WILLIAM ASHLINE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-6195
MR. ROBERT LUND IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (864) 201-6478
JOHN DAVID MACLEOD
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (716) 955-9805
STEVEN LE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
WILLIAM ALLEN IRISH IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
APO, AP 92134
San Diego County (619) 532-6195
TIMOTHY JOHN RUANE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
OLIVIA KROHTA
Student in an Organized Health Care Education/Training Program
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
JARED MICHAEL O'BRIEN
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dallas Dudelston's NPI number?

The NPI number for Dallas Dudelston is 1508739103. It was assigned to this individual provider in the NPPES registry on September 29, 2025.

Where is Dallas Dudelston located?

Dallas Dudelston practices at 34101 Farenholt Ave Bldg 14, San Diego, CA 92134. The listed phone number is (765) 209-0919.

What is Dallas Dudelston's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Dallas Dudelston was last updated on September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.