Individual provider · Type 1 NPI

Jordan Dietrich, DDS

General Practice Dentistry · Wautoma, WI

NPI number 1902582604 Active

Practice location

400 S Townline Rd
Wautoma, WI 54982-6922

Call (920) 787-5514 Map

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X6001224-15 (WI)

General Practice Dentistry: 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.

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About NPI 1902582604

Jordan Dietrich, DDS's National Provider Identifier is 1902582604, issued on Jun 26, 2023. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Wautoma, WI. The record was last updated on Oct 2, 2025.