Provider Demographics
NPI:1841402039
Name:DENDINGER, DONALD JOHN (MPT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOHN
Last Name:DENDINGER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1874 TICE VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-2224
Mailing Address - Country:US
Mailing Address - Phone:925-935-0510
Mailing Address - Fax:925-935-0750
Practice Address - Street 1:1874 TICE VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2224
Practice Address - Country:US
Practice Address - Phone:925-935-0510
Practice Address - Fax:925-935-0750
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT212770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21402ZMedicare ID - Type Unspecified