Provider Demographics
NPI:1689795858
Name:DINKINS, LINDA GAIL (MPH, LDN, RD)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:GAIL
Last Name:DINKINS
Suffix:
Gender:F
Credentials:MPH, LDN, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 OCONEE PL
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-5407
Mailing Address - Country:US
Mailing Address - Phone:504-621-7355
Mailing Address - Fax:813-501-1132
Practice Address - Street 1:6801 OCONEE PL
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-5407
Practice Address - Country:US
Practice Address - Phone:504-621-7355
Practice Address - Fax:813-501-1132
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002944133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C345Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER