Provider Demographics
NPI:1104905413
Name:PINGEL, DEAN HERMAN (DC)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:HERMAN
Last Name:PINGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1185
Mailing Address - Street 2:19 10TH ST SW
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-1185
Mailing Address - Country:US
Mailing Address - Phone:712-262-4315
Mailing Address - Fax:712-262-4470
Practice Address - Street 1:19 10TH ST SW
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-1185
Practice Address - Country:US
Practice Address - Phone:712-262-4315
Practice Address - Fax:712-262-4470
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA094987Medicaid
T00717Medicare UPIN
09498Medicare ID - Type Unspecified