Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
LEEANN DIERCKS
Active
Individual
LEEANN DIERCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1113
SD
122300000X
Dentist
D13356
MN
Other
Enumeration date
05/19/2014
Last updated
06/22/2016
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