MEDICARE: GRACE DINKELAKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1063362549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE DINKELAKER

Provider Business Mailing Address
First Line	:	6150 WINDING CREEK BLVD
Second Line	:
City	:	LIBERTY TWP
State	:	OH
Zip	:	45011-2685
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 DELHI RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45233-1669
Country	:	US
Telephone Number	:	513-244-4200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	04/07/2026

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Directions to “ GRACE DINKELAKER ” Practice Location

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