1124061429 NPI number — YOLANDA E DINGESS MD

Table of content: YOLANDA E DINGESS MD (NPI 1124061429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124061429 NPI number — YOLANDA E DINGESS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DINGESS
Provider First Name:
YOLANDA
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124061429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4262 OLD WILLIAM PENN HWY
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
MURRYSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15668-1936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-325-2133
Provider Business Mailing Address Fax Number:
724-733-2278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4262 OLD WILLIAM PENN HWY
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
MURRYSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15668-1936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-325-2133
Provider Business Practice Location Address Fax Number:
724-733-2278
Provider Enumeration Date:
06/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD042398L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4321231 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 370017091 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 712843 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 207531 . This is a "UPMC HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P000179 . This is a "GATEWAY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001231746 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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