Provider Demographics
NPI:1588837900
Name:NEWBERN, DOROTHEE KIM DANG (MD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHEE
Middle Name:KIM DANG
Last Name:NEWBERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DOROTHEE
Other - Middle Name:DUC
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3200 E CAMELBACK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2327
Mailing Address - Country:US
Mailing Address - Phone:602-933-1814
Mailing Address - Fax:
Practice Address - Street 1:1920 E CAMBRIDGE AVE STE 301
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1464
Practice Address - Country:US
Practice Address - Phone:602-933-0935
Practice Address - Fax:602-933-2471
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127886208000000X, 2080P0205X
AZ479192080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ815555Medicaid