Healthcare Provider Details

I. General information

NPI: 1083877344
Provider Name (Legal Business Name): SABRINA DIANE DINKHA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13750 S SEDONA PARKWAY SUITE 2
LANSING MI
48906
US

IV. Provider business mailing address

804 SERVICE RD A201
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-669-9758
  • Fax: 517-679-8232
Mailing address:
  • Phone: 517-884-2976
  • Fax: 517-432-3928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101017606
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: