Provider Demographics
NPI:1568510501
Name:SANGALANG, DAWN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:SANGALANG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 E 10TH ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3710
Mailing Address - Country:US
Mailing Address - Phone:317-898-5800
Mailing Address - Fax:317-898-5883
Practice Address - Street 1:11020 E 10TH ST
Practice Address - Street 2:UNIT B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3710
Practice Address - Country:US
Practice Address - Phone:317-898-5800
Practice Address - Fax:317-898-5883
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001241A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100131660Medicaid
IN000000088460OtherBCBS
INU10905Medicare UPIN
IN000000088460OtherBCBS