Provider Demographics
NPI:1053375691
Name:DILLINGER, DAWN C (DO)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:C
Last Name:DILLINGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 INAH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1705
Mailing Address - Country:US
Mailing Address - Phone:614-878-6415
Mailing Address - Fax:614-878-7946
Practice Address - Street 1:111 INAH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1705
Practice Address - Country:US
Practice Address - Phone:614-878-6415
Practice Address - Fax:614-878-7946
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-8515208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2568332Medicaid
OH2568332Medicare ID - Type Unspecified