Provider Demographics
NPI:1629127626
Name:DHINDSA UROLOGY, P.C.
Entity type:Organization
Organization Name:DHINDSA UROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AVTAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:DHINDSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-477-5178
Mailing Address - Street 1:2102 EVANS AVE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4095
Mailing Address - Country:US
Mailing Address - Phone:219-477-5178
Mailing Address - Fax:219-465-4283
Practice Address - Street 1:2102 EVANS AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4095
Practice Address - Country:US
Practice Address - Phone:219-477-5178
Practice Address - Fax:219-465-4283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041877B208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15DO876486OtherCLIA
IN15DO876486OtherCLIA
IN658300AMedicare ID - Type Unspecified