Healthcare Provider Details
I. General information
NPI: 1730101890
Provider Name (Legal Business Name): DARRELL GINSBERG D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2006
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 E MAIN ST
MANCHESTER IA
52057-1838
US
IV. Provider business mailing address
13723 76TH AVE
FLUSHING NY
11367-2817
US
V. Phone/Fax
- Phone: 563-927-5415
- Fax:
- Phone: 917-515-9322
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DDS-09620 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: