Provider Demographics
NPI:1821243627
Name:NEWMAN, DIRK A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIRK
Middle Name:A
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5977 E GRANT RD STE 115
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2341
Mailing Address - Country:US
Mailing Address - Phone:520-296-5439
Mailing Address - Fax:520-296-4584
Practice Address - Street 1:5977 E GRANT RD STE 115
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2341
Practice Address - Country:US
Practice Address - Phone:520-296-5439
Practice Address - Fax:520-296-4584
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5812015122300000X
AZD008902122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist