Provider Demographics
NPI:1821526864
Name:DIMMER, ANNA (OD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DIMMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1018 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6625
Mailing Address - Country:US
Mailing Address - Phone:319-338-9275
Mailing Address - Fax:
Practice Address - Street 1:1018 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6625
Practice Address - Country:US
Practice Address - Phone:319-338-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist