Provider Demographics
NPI:1093019572
Name:NOAH C. DEHLINGER, DDS, INC.
Entity Type:Organization
Organization Name:NOAH C. DEHLINGER, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:CHRIS
Authorized Official - Last Name:DEHLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-457-9242
Mailing Address - Street 1:160 SIR FRANCIS DRAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-2539
Mailing Address - Country:US
Mailing Address - Phone:415-457-9242
Mailing Address - Fax:415-453-2131
Practice Address - Street 1:160 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2539
Practice Address - Country:US
Practice Address - Phone:415-457-9242
Practice Address - Fax:415-453-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA523711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty