Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Robert J Diecidue, DMD, MD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1225069818

Dr. Robert J Diecidue, DMD, MD is an Oral Surgery in Philadelphia, Pennsylvania. Qualified in 1988, 38 years ago. Practices with Jefferson University Physicians, a 1,554-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
38
Licensed in
PA
In the registry since
2006
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

909 Walnut St 3rd Fl Cob
Philadelphia, PA 19107-5211
Phone: (215) 955-6215
Fax: (215) 923-9189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence MD421272 (PA)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence DS026243L (PA)

Record details

NPI number1225069818
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD , MD
Sole proprietorNo
NPI enumeratedJuly 5, 2006
Last updated in NPPESAugust 23, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Jefferson University Physicians — 1554 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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