Provider Demographics
NPI:1255311205
Name:DINELLO, DONALD D (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:D
Last Name:DINELLO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9429
Mailing Address - Country:US
Mailing Address - Phone:717-657-8564
Mailing Address - Fax:717-657-2601
Practice Address - Street 1:2405 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9429
Practice Address - Country:US
Practice Address - Phone:717-657-8564
Practice Address - Fax:717-657-2601
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADA017217A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA127461Medicare ID - Type Unspecified
PAT27182Medicare UPIN