Provider Demographics
NPI:1114028602
Name:DINGEMAN, ROBERT DENISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DENISON
Last Name:DINGEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 OLD RICHARDSON HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7813
Mailing Address - Country:US
Mailing Address - Phone:907-452-2663
Mailing Address - Fax:907-456-3033
Practice Address - Street 1:751 OLD RICHARDSON HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7813
Practice Address - Country:US
Practice Address - Phone:907-452-2663
Practice Address - Fax:907-456-3033
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK2137207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD9915Medicaid
AKK0000BJBJZMedicare ID - Type Unspecified
AKMD9915Medicaid