Healthcare Provider Details

I. General information

NPI: 1932469350
Provider Name (Legal Business Name): DINA DAHDAL MD
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8619 CHICOT RD # 2
LITTLE ROCK AR
72209-4445
US

IV. Provider business mailing address

8619 CHICOT RD # 2
LITTLE ROCK AR
72209-4445
US

V. Phone/Fax

Practice location:
  • Phone: 501-850-6288
  • Fax: 501-850-6927
Mailing address:
  • Phone: 936-200-4476
  • Fax: 501-850-6927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301100660
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301100660
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberE-9957
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number34321
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: