Provider Type Icon

PAUL D. DIBLEY D.D.S. S.C. NPI 1720078512


NPI Information

NPI: 1720078512
Provider Name: PAUL D. DIBLEY, D.D.S., S.C.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
920 E 5TH ST
SHAWANO, WI
ZIP 54166
Phone: (715) 526-3315
Get Directions

PAUL D. DIBLEY, D.D.S., S.C. is a general practice dentist in Shawano, WI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PAUL D. DIBLEY, D.D.S., S.C. NPI is 1720078512. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

920 E 5TH ST
SHAWANO, WI
ZIP 54166-212
Phone: (715) 526-3315

The provider's authorized official is Paul D. Dibley .
The authorized official title is President and has the following contact phone number (715) 526-3315.

The enumeration date for this NPI number is 10/24/2005 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice5001351015WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
133617100MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.