Provider Demographics
NPI:1538127568
Name:GABAEFF, DINA ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:ROBIN
Last Name:GABAEFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PALOMINO LANE
Mailing Address - Street 2:#100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4894
Mailing Address - Country:US
Mailing Address - Phone:702-759-8600
Mailing Address - Fax:702-384-1815
Practice Address - Street 1:2020 PALOMINO LANE
Practice Address - Street 2:#100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4894
Practice Address - Country:US
Practice Address - Phone:702-759-8600
Practice Address - Fax:702-384-1815
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ248032085N0700X
NC2023-034252085R0202X
NV147712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1538127568Medicaid
AZAZ0324990OtherBCBS
AZ378035OtherAHCCCS
NVP01190313OtherRR MEDICARE DESERT RADIOLOGY SOLUTIONS LLC
NVP01197941OtherRR MEDICARE
AZ1Z7049OtherHEALTHNET
AZ378035OtherAHCCCS
AZ1Z7049OtherHEALTHNET
AZWDBBFMedicare ID - Type Unspecified
NVHE490XMedicare PIN
AZG44393Medicare UPIN