LYDIA J DIEKMANN


Address: 2711 Broadway Ave Ste A00, Slayton, MN 56172-1313
Phone: 5078361000

LYDIA J DIEKMANN (NPI# 1144733130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144733130
Entity Type Individual
Full Name LYDIA J DIEKMANN
Credential ADT
Practice Address 2711 Broadway Ave Ste A00
Slayton
MN 56172-1313
Practice Telephone 5078361000
Practice Fax Number 5078361008
Mailing Telephone 5078361000
Mailing Fax Number 5078361008
Enumeration Date 2017-11-13
Last Update Date 2017-11-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 125K00000X Advanced Practice Dental Therapist DT37 MN Dental Providers

Office Location

Street Address 2711 BROADWAY AVE STE A00
City SLAYTON
State MN
Zip Code 56172-1313

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023454873 Rachel Isder Registered Nurse 3001 Maple Road, Slayton, MN 56172 2013-05-21
1184785024 Prairie View Intermediate Care Facility, Mentally Retarded 2220 27th St, Slayton, MN 56172 2006-12-13
1770778540 Brian A Chabot Physician Assistant 2042 Juniper Ave, Slayton, MN 56172 2007-09-13
1588778658 Anthony C Nwakama Orthopaedic Surgery 2331 20th St, Slayton, MN 56172-1004 2006-08-18
1083967244 Connect Hearing, Inc. Audiologist 2331 20th St, Slayton, MN 56172-1004 2012-10-24
1083778021 Southwest Minnesota Orthopedics and Sports Medicine, Inc. Orthopaedic Surgery 2331 20th St, Slayton, MN 56172-1004 2006-12-21
1245677590 Sltn Pharmacy Services, Ltd. Pharmacy 2010 Juniper Ave, Slayton, MN 56172-1017 2013-05-28
1053497214 County of Murray General Acute Care Hospital 2042 Juniper Ave, Slayton, MN 56172-1017 2006-10-31
1942202403 Stacy Wahl Slettum Nurse Practitioner 2040 Juniper Ave, Slayton, MN 56172-1017 2005-08-15
1720560089 Tracy Lynn Hansen Nurse Practitioner 2040 Juniper Ave, Slayton, MN 56172-1017 2018-09-04
Find all providers in zip 56172

Taxonomy Information

Taxonomy Code 125K00000X
Grouping Dental Providers
Classification Advanced Practice Dental Therapist

Taxonomy Definition

An Advanced Practice Dental Therapist is:
(1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or
(2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum.

The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations.
Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578117438 Christina Marie Hubred Advanced Practice Dental Therapist Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 2019-07-30
1073872503 Brieanne Kelsey Borntrager Advanced Practice Dental Therapist 13899 Hwy 13 S Frnt Rd, Savage, MN 55378-2135 2012-05-03
1023541695 Carley Banks Advanced Practice Dental Therapist 1575 20th St Nw, Faribault, MN 55021 2017-04-10
1033642947 Lauren Johnson Advanced Practice Dental Therapist 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 2017-04-07
1063953032 Ashley Hueman Advanced Practice Dental Therapist 973 Skyline Dr Sw, Rochester, MN 55902-1220 2017-03-10
1124483656 Tanu Dhoopar Advanced Practice Dental Therapist 3152 Minnehaha Ave, Minneapolis, MN 55406-1934 2015-12-29
1548631187 Kaitlin Siewert Advanced Practice Dental Therapist 520 Main Street, Hawley, MN 56549 2015-10-08

Competitor

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City SLAYTON
Zip Code 56172

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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