1609064435 NPI number — ADVANCED WOMEN'S HEALTHCARE, A MEDICAL CORPORATION

Table of content: DENNIS ALAN DAHL DDS (NPI 1750414504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609064435 NPI number — ADVANCED WOMEN'S HEALTHCARE, A MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED WOMEN'S HEALTHCARE, A MEDICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1609064435
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41990 COOK ST STE H701
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM DESERT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92211-6103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-327-7900
Provider Business Mailing Address Fax Number:
760-327-7905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41990 COOK ST STE H701
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM DESERT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92211-6103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-564-7900
Provider Business Practice Location Address Fax Number:
760-327-7905
Provider Enumeration Date:
10/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FERGON
Authorized Official First Name:
JOLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT & CFO
Authorized Official Telephone Number:
760-327-7900

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X , with the licence number:  A86905 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: GR0101242 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".