Provider Demographics
NPI:1255614392
Name:DINGLEY, ERIK (OD)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:DINGLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 POND ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-2006
Mailing Address - Country:US
Mailing Address - Phone:401-769-6323
Mailing Address - Fax:401-769-9202
Practice Address - Street 1:621 POUND HILL RD STE 104
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-9358
Practice Address - Country:US
Practice Address - Phone:401-769-6323
Practice Address - Fax:401-769-9202
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002548152W00000X
RIODTG000571152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIED89889Medicaid