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DOUGLAS NORMAN DEDERICH DDS, PHD
NPI 1932949203
Dentist - Periodontics in Glendale, WI

Active since May 25, 2024
500 W SILVER SPRING DR STE K250, GLENDALE, WI 53217(414) 963-2301 Get Directions Write a Review

NPPES record last updated: May 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Douglas Norman Dederich Dds, Phd NPPES

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

DOUGLAS NORMAN DEDERICH DDS, PHD (NPI 1932949203) is an individual periodontics provider in Glendale, Wisconsin, licensed in Wisconsin (3322-15) and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1932949203
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDOUGLAS NORMAN DEDERICHCredential: DDS, PHD
Location Address500 W SILVER SPRING DR STE K250Glendale, WI 53217-5062
Mailing Address6330 W Greenfield Ave Apt 408Milwaukee, WI 53214-5073 · (780) 868-1562
Phone(414) 963-2301
Sole ProprietorYes
Enumeration DateMay 25, 2024
NPPES CertifiedMay 25, 2024
✔ NPI 1932949203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in WI · 3322-15
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
500 W SILVER SPRING DR STE K250, Glendale, WI 53217
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Other Providers at the Same Location NPPES 2

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

ADVANCED DENTAL SPECIALISTS, LLC
Dentist (General Practice)
500 W SILVER SPRING DR STE K250
GLENDALE, WI 53217
Milwaukee County (414) 529-5330
WISCONSIN DENTAL GROUP, S.C.
Dentist (General Practice)
500 W SILVER SPRING DR STE K250
GLENDALE, WI 53217
Milwaukee County (262) 363-2220

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 Douglas Dederich's NPI number?

The NPI number for Douglas Dederich is 1932949203. It was assigned to this individual provider in the NPPES registry on May 25, 2024.

Where is Douglas Dederich located?

Douglas Dederich practices at 500 W Silver Spring Dr Ste K250, Glendale, WI 53217. The listed phone number is (414) 963-2301.

What is Douglas Dederich's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does Douglas Dederich accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Douglas Dederich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Dederich was last updated on May 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.