Provider Demographics
NPI:1801580162
Name:DAKDOUK, DEANNA
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:DAKDOUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5777 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-1952
Mailing Address - Country:US
Mailing Address - Phone:216-577-5105
Mailing Address - Fax:
Practice Address - Street 1:5777 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-1952
Practice Address - Country:US
Practice Address - Phone:216-577-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant