Provider Demographics
NPI:1902491582
Name:DIONISE, EMMA KATHRYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:KATHRYN
Last Name:DIONISE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2594
Mailing Address - Country:US
Mailing Address - Phone:336-286-0200
Mailing Address - Fax:
Practice Address - Street 1:8920 WEST CONNELL COURT
Practice Address - Street 2:
Practice Address - City:MIWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-266-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC117281223P0221X
FL242571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry