Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jordan Dietrich, DDS

Individual provider General Practice Dentistry · NPI 1902582604

Dr. Jordan Dietrich, DDS is a General Practice Dentistry in Wautoma, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2023.

Licensed in
WI
In the registry since
2023
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

400 S Townline Rd
Wautoma, WI 54982-6922
Phone: (920) 787-5514
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 6001224-15 (WI)

Record details

NPI number1902582604
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 26, 2023
Last updated in NPPESOctober 2, 2025
Certification dateOctober 2, 2025

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