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General NPI Number Information
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NPI Number | 1114840048
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Entity Type | Individual
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Provider Name | JACK DIENES AUD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 542 N LEWIS RD STE 101
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City | LIMERICK
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State | PA
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Zip | 19468-3521
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Country | US
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Telephone | 610-323-1550
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 CHANTILLY LN
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-1732
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Country | US
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Telephone | 484-885-4585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AT007123
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License Number State | PA
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