Basic Information
Provider Information
NPI: 1720441959
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DONDLINGER
FirstName: STEVEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7595 ANAGRAM DR
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553447399
CountryCode: US
TelephoneNumber: 6125732200
FaxNumber: 6125732274
Practice Location
Address1: 7595 ANAGRAM DR
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553447399
CountryCode: US
TelephoneNumber: 6125732200
FaxNumber: 6125732250
Other Information
ProviderEnumerationDate: 04/04/2016
LastUpdateDate: 07/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X2020-00821NCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X70399MNY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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