1023484904 NPI number — DANIEL ADAM DIPIRRO JR. DDS

Table of content: DANIEL ADAM DIPIRRO JR. DDS (NPI 1023484904)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023484904 NPI number — DANIEL ADAM DIPIRRO JR. DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIPIRRO
Provider First Name:
DANIEL
Provider Middle Name:
ADAM
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
DDS
Provider Gender Code:
M

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:
1023484904
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10590 ENDURING FREEDOM DR
Provider Second Line Business Mailing Address:
US ARMY DENTAL ACTIVITY ATTN: CREDENTIALS OFFICE
Provider Business Mailing Address City Name:
FORT DRUM
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13602-5005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36000 DARNALL LOOP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544-5095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-287-3105
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2015

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: 122300000X , with the licence number:  DS040586 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0300X , with the licence number: DS040586 , 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)





Copyright © 2007-2025 www.npivalidator.com