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General NPI Number Information
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NPI Number | 1881936177
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Entity Type | Individual
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Provider Name | DUSTIN DIPPEN MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 99 MAPLE ST STE 14
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1231
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Country | US
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Telephone | 802-316-8693
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Fax | 608-360-9104
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Provider Business Mailing Address
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Address Line | 99 MAPLE ST STE 14
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1231
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Country | US
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Telephone | 802-316-8693
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 67066
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0062327
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 042.0013408
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License Number State | VT
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