Provider Demographics
NPI:1497255699
Name:PARKINSON, DALLIN CLARK (DMD)
Entity Type:Individual
Prefix:
First Name:DALLIN
Middle Name:CLARK
Last Name:PARKINSON
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 1:6452 E CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2212
Mailing Address - Country:US
Mailing Address - Phone:520-296-3000
Mailing Address - Fax:520-733-9000
Practice Address - Street 1:6452 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2212
Practice Address - Country:US
Practice Address - Phone:520-296-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS2-205C1223S0112X
IARES-30525390200000X
AZD0113051223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program