Provider Demographics
NPI:1326245796
Name:PINGEL, KIMBERLY VICTORIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:VICTORIA
Last Name:PINGEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:957 MAIN ST UNIT 301
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6710
Mailing Address - Country:US
Mailing Address - Phone:612-219-4351
Mailing Address - Fax:
Practice Address - Street 1:100 BRYANT ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-7405
Practice Address - Country:US
Practice Address - Phone:563-557-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088971223S0112X
WI6857-151223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery