Healthcare Provider Details

I. General information

NPI: 1689094534
Provider Name (Legal Business Name): DAKOTA M URBAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 OMEGA DR
NEWARK DE
19713-2059
US

IV. Provider business mailing address

62 OMEGA DR BLDG E
NEWARK DE
19713-2059
US

V. Phone/Fax

Practice location:
  • Phone: 302-368-9611
  • Fax: 302-368-3424
Mailing address:
  • Phone: 302-574-0214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0013144
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: