CARDINAL DERMATOLOGY LLC – NPI #1174390926
Dermatology

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

CARDINAL DERMATOLOGY LLC is a dermatologist located in SOUTH BEND, IN. NPPES has assigned the NPI number 1174390926 to CARDINAL DERMATOLOGY LLC on December 11, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology.

The NPI profile was last updated on Jan 02, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CARDINAL DERMATOLOGY LLC below.

NPI Profile for
CARDINAL DERMATOLOGY LLC

NPI Number
1174390926
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CARDINAL DERMATOLOGY LLC
Primary location
4322 LAFAYETTE BLVD
SOUTH BEND, IN 46614
Phone: (574) 391-1111 Fax:
Mailing address
4322 S LAFAYETTE BLVD
SOUTH BEND, IN 46614-2189
Phone: (574) 391-1111 Fax: (574) 859-5040
Organization Subpart
No
Authorized Official
LUIZ PANTALENA FILHO
MEMBER
Phone: (650) 387-9765
Updated
Certification Date
Dec 31, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207N00000X
- Dermatology (Primary)
207NS0135X
- Dermatology / Procedural Dermatology
207ND0101X
- Dermatology / MOHS-Micrographic Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.