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General NPI Number Information
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NPI Number | 1366246746
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Entity Type | Individual
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Provider Name | SAMANTHA DIERINGER RDH, OMT
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 2017 E PIKE ST
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City | CLARKSBURG
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State | WV
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Zip | 26301-6013
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Country | US
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Telephone | 304-623-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 TANGLEWOOD RD
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City | BRIDGEPORT
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State | WV
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Zip | 26330-9381
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Country | US
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Telephone | 304-629-2118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2972
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License Number State | WV
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