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General NPI Number Information
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NPI Number | 1588120851
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Entity Type | Individual
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Provider Name | JEREMY SCOTT DINKIN DC
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Gender | Male
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 908 OAK TREE AVE
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-5100
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Country | US
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Telephone | 732-603-0783
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Fax |
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Provider Business Mailing Address
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Address Line | 700 BANGS AVE UNIT 214
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City | ASBURY PARK
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State | NJ
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Zip | 07712-6958
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Country | US
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Telephone | 732-996-6185
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00759100
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License Number State | NJ
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