Healthcare Provider Details

I. General information

NPI: 1083548580
Provider Name (Legal Business Name): DICERBO & IRVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 FALLON AVE
SEAFORD DE
19973-1597
US

IV. Provider business mailing address

18947 JOHN J WILLIAMS HWY UNIT 309
REHOBOTH BEACH DE
19971-4477
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-4460
  • Fax:
Mailing address:
  • Phone: 302-644-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMY MACEO IRVING
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 302-644-4460