MEDICARE: DENNIS KING

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	103G00000X	Clinical Neuropsychologist

General Provider Information

NPI Number	:	1982547055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS KING

Provider Business Mailing Address
First Line	:	614 BENNINGTON ST APT 2
Second Line	:
City	:	EAST BOSTON
State	:	MA
Zip	:	02128-4231
Country	:	US
Telephone Number	:	781-687-4738
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 SPRINGS RD BLDG 5
Second Line	:
City	:	BEDFORD
State	:	MA
Zip	:	01730-1198
Country	:	US
Telephone Number	:	781-687-4738
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ DENNIS KING ” Practice Location

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