Provider Demographics
NPI:1144774613
Name:DINGLASAN SR MD, JOSEPH LOCHINVAR SR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LOCHINVAR
Last Name:DINGLASAN SR MD
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 NORTHFALL LN
Mailing Address - Street 2:SUITE 1405
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7976
Mailing Address - Country:US
Mailing Address - Phone:404-748-5249
Mailing Address - Fax:
Practice Address - Street 1:709 BOWCREEK DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1885
Practice Address - Country:US
Practice Address - Phone:770-895-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0187992082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck