Provider Demographics
NPI:1801023981
Name:ORLANDO, DOMINIC (OD)
Entity Type:Individual
Prefix:DR
First Name:DOMINIC
Middle Name:
Last Name:ORLANDO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9441
Mailing Address - Country:US
Mailing Address - Phone:850-445-6572
Mailing Address - Fax:
Practice Address - Street 1:684 N WEST END BLVD
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-4100
Practice Address - Country:US
Practice Address - Phone:215-536-7023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003020152W00000X
ALS-C09-TA-835152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS-C09-TA-835OtherSTATE LICENSE
PAOEG003020OtherSTATE LICENSE