Provider Demographics
NPI:1306055744
Name:DYKES, DANA MICHELLE HINES (MD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE HINES
Last Name:DYKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 JOHNSON FY RD NE # D
Mailing Address - Street 2:SUITE 440
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-257-0799
Mailing Address - Fax:404-503-2280
Practice Address - Street 1:993 JOHNSON FY RD NE # D
Practice Address - Street 2:SUITE 440
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-257-0799
Practice Address - Fax:404-503-2280
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.093447208000000X, 2080P0206X
GA776162080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics