Provider Demographics
NPI:1831133404
Name:GIORDANO, DENNIS EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:EDWARD
Last Name:GIORDANO
Suffix:
Gender:M
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:PO BOX 63111
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3111
Mailing Address - Country:US
Mailing Address - Phone:800-889-4447
Mailing Address - Fax:610-956-0009
Practice Address - Street 1:3010 TRENWEST DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3208
Practice Address - Country:US
Practice Address - Phone:336-970-5300
Practice Address - Fax:336-970-5298
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2326932085R0202X
NC2018-026952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02833769Medicaid
NY881S31Medicare PIN