Provider Demographics
NPI:1093054157
Name:DINAN, JOHN EDWARD JR (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:DINAN
Suffix:JR
Gender:M
Credentials:DMD, MS
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Mailing Address - Street 1:630 FIFTH AVE
Mailing Address - Street 2:SUITE 1857
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10111-1868
Mailing Address - Country:US
Mailing Address - Phone:212-969-9166
Mailing Address - Fax:212-265-1767
Practice Address - Street 1:630 FIFTH AVE
Practice Address - Street 2:SUITE 1857
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10111-1868
Practice Address - Country:US
Practice Address - Phone:212-969-9166
Practice Address - Fax:212-265-1767
Is Sole Proprietor?:No
Enumeration Date:2013-02-10
Last Update Date:2024-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ22DI025423001223X2210X
NY062947-011223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain