Provider Demographics
NPI:1588685598
Name:DONALD D DINELLO, DMD, PC
Entity Type:Organization
Organization Name:DONALD D DINELLO, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-657-8564
Mailing Address - Street 1:2405 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9429
Mailing Address - Country:US
Mailing Address - Phone:717-657-8564
Mailing Address - Fax:717-657-2601
Practice Address - Street 1:2405 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9429
Practice Address - Country:US
Practice Address - Phone:717-657-8564
Practice Address - Fax:717-657-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA17226Medicare ID - Type UnspecifiedDONALD JOSEPH DINELLO
PAT27182Medicare UPIN
PA127461Medicare ID - Type UnspecifiedDONALD D DINELLO
PAU75062Medicare UPIN