Provider Demographics
NPI:1205115912
Name:PAUL D. DINGMAN PA
Entity type:Organization
Organization Name:PAUL D. DINGMAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:DINGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:763-788-9101
Mailing Address - Street 1:3984 CENTRAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3931
Mailing Address - Country:US
Mailing Address - Phone:763-788-9101
Mailing Address - Fax:763-789-4980
Practice Address - Street 1:3984 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-3931
Practice Address - Country:US
Practice Address - Phone:763-788-9101
Practice Address - Fax:763-789-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2701111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44-82648OtherMEDICA
MN504828100Medicaid
MN71229-NOOtherBLUECROSS BLUESHIELD
MN44-82648OtherMEDICA