Provider Demographics
NPI:1548354277
Name:PANGILINAN, DIOSDADO (DDS)
Entity type:Individual
Prefix:DR
First Name:DIOSDADO
Middle Name:
Last Name:PANGILINAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 WEST PERIMETER ROAD
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE ANDREWS
Mailing Address - State:MD
Mailing Address - Zip Code:20762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1065 WEST PERIMETER ROAD
Practice Address - Street 2:
Practice Address - City:JOINT BASE ANDREWS
Practice Address - State:MD
Practice Address - Zip Code:20762
Practice Address - Country:US
Practice Address - Phone:240-857-5029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist