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NPI Code Detail

MEDICARE: DR. KIMBERLY VICTORIA PINGEL DDS

MEDICARE: DR. KIMBERLY VICTORIA PINGEL DDS
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
11223S0112XOral and Maxillofacial Surgery (Dentist)08897IA
21223S0112XOral and Maxillofacial Surgery (Dentist)6857-15WI

General Provider Information

NPI Number : 1326245796
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY VICTORIA PINGEL DDS
Provider Business Mailing Address
First Line : 957 MAIN ST UNIT 301
Second Line :
City : DUBUQUE
State : IA
Zip : 52001-6710
Country : US
Telephone Number : 612-219-4351
Fax Number :
Provider Business Practice Location Address
First Line : 100 BRYANT ST
Second Line :
City : DUBUQUE
State : IA
Zip : 52003-7405
Country : US
Telephone Number : 563-557-7001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 08/08/2012

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Directions to “ DR. KIMBERLY VICTORIA PINGEL DDS” Practice Location

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