Provider Demographics
NPI:1972509248
Name:BENASSI, DANA MARIE (DC)
Entity type:Individual
Prefix:MISS
First Name:DANA
Middle Name:MARIE
Last Name:BENASSI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 WHITE BEAR AVE N
Mailing Address - Street 2:STE 100
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5166
Mailing Address - Country:US
Mailing Address - Phone:651-770-8091
Mailing Address - Fax:651-770-8781
Practice Address - Street 1:2580 WHITE BEAR AVE N
Practice Address - Street 2:STE 100
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5166
Practice Address - Country:US
Practice Address - Phone:651-770-8091
Practice Address - Fax:651-770-8781
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4352111N00000X
MN670171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN20552BEOtherBLUE CROSS BLUE SHIELD
MN20552BEOtherBLUE CROSS BLUE SHIELD