Provider Demographics
NPI:1861694309
Name:DANI, DHIMANT (MD)
Entity type:Individual
Prefix:
First Name:DHIMANT
Middle Name:
Last Name:DANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 W PARKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-7334
Mailing Address - Country:US
Mailing Address - Phone:330-995-1441
Mailing Address - Fax:
Practice Address - Street 1:1050 W PARKWAY BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-7334
Practice Address - Country:US
Practice Address - Phone:330-995-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.0948952084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0022452OtherINSTITUTIONAL PERMIT