Provider Demographics
NPI:1598860306
Name:DINGLE, ARDEN D (MD)
Entity Type:Individual
Prefix:
First Name:ARDEN
Middle Name:D
Last Name:DINGLE
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 1:1664 N VIRGINIA ST # MS 1332
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0001
Mailing Address - Country:US
Mailing Address - Phone:775-682-8175
Mailing Address - Fax:775-327-2009
Practice Address - Street 1:5190 NEIL RD STE 215
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6509
Practice Address - Country:US
Practice Address - Phone:775-784-6388
Practice Address - Fax:775-327-5218
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV199102084P0804X
TXQ36652084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX353718502OtherMEDICAID-CSHCN
TX353718501Medicaid
TX353718501Medicaid
TX447430ZK0DMedicare PIN