Provider Demographics
NPI:1891841078
Name:DIEHNELT, DAWN ELLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:ELLA
Last Name:DIEHNELT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3401
Mailing Address - Country:US
Mailing Address - Phone:847-818-0700
Mailing Address - Fax:847-818-0705
Practice Address - Street 1:1328 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3401
Practice Address - Country:US
Practice Address - Phone:847-818-0700
Practice Address - Fax:847-818-0705
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice