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1518964154

NPI Code Detail

MEDICARE: DR. DOUGLAS EDWARD DENNETT MD

MEDICARE: DR. DOUGLAS EDWARD DENNETT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	0420007975	VT
2	2084P0800X	Psychiatry Physician	0420007975	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00009967	OTHER	VT	BCBS
2	20P005	OTHER	VT	MVP
3	71747	OTHER	VT	CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518964154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS EDWARD DENNETT MD

Provider Business Mailing Address
First Line	:	8 CARMICHAEL ST
Second Line	:	UNIT 204
City	:	ESSEX JCT
State	:	VT
Zip	:	05452-3216
Country	:	US
Telephone Number	:	802-872-9263
Fax Number	:	802-872-8222

Provider Business Practice Location Address
First Line	:	8 CARMICHAEL ST
Second Line	:	UNIT 204
City	:	ESSEX JCT
State	:	VT
Zip	:	05452-3216
Country	:	US
Telephone Number	:	802-872-9263
Fax Number	:	802-872-8222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/19/2015

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1497743827 — DR. SANDRA E KAPSALIS M.D.
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Directions to “ DR. DOUGLAS EDWARD DENNETT MD” Practice Location

Language	Start Address	Practice Location

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