1659974095 NPI number — NICHOLAS ANTHONY DINARIS BCBA, LBA

Table of content: NICHOLAS ANTHONY DINARIS BCBA, LBA (NPI 1659974095)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659974095 NPI number — NICHOLAS ANTHONY DINARIS BCBA, LBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DINARIS
Provider First Name:
NICHOLAS
Provider Middle Name:
ANTHONY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BCBA, LBA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DINAPOLI
Provider Other First Name:
NICHOLAS
Provider Other Middle Name:
ANTHONY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659974095
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2034 COLUMBIA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT HELENS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97051-1737
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:
35441 OAKWOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT HELENS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97051-2756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-697-8745
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2020

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: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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