Provider Demographics
NPI:1265498117
Name:TELANG, DINESH JOHN (MD)
Entity Type:Individual
Prefix:
First Name:DINESH
Middle Name:JOHN
Last Name:TELANG
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 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4034
Mailing Address - Fax:970-490-4347
Practice Address - Street 1:175 S UNION BLVD STE 315
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3126
Practice Address - Country:US
Practice Address - Phone:719-365-3700
Practice Address - Fax:719-365-3701
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDT052731208800000X
MI4301052731208800000X
CODR.0067744208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E06273OtherMEDICARE
MI3049417Medicaid
MIDT052731OtherLICENSE
MI3405078782OtherBCBSM
F73933Medicare UPIN
MIDT052731OtherLICENSE
MI3405078782OtherBCBSM