Provider Demographics
NPI:1174691802
Name:DI JINIO, DONNA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:DI JINIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4729 KUTZTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560
Mailing Address - Country:US
Mailing Address - Phone:610-921-8129
Mailing Address - Fax:610-685-7375
Practice Address - Street 1:4729 KUTZTOWN ROAD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560
Practice Address - Country:US
Practice Address - Phone:610-921-8129
Practice Address - Fax:610-685-7375
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021668L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice