Healthcare Provider Details

I. General information

NPI: 1477522373
Provider Name (Legal Business Name): JAMES ERIC DENNEMEYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8573 E SAN ALBERTO STE E100
SCOTTSDALE AZ
85258-4612
US

IV. Provider business mailing address

844 N THORNTON AVE
ORLANDO FL
32803-4003
US

V. Phone/Fax

Practice location:
  • Phone: 480-778-1732
  • Fax: 480-778-1709
Mailing address:
  • Phone: 407-398-6470
  • Fax: 407-894-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 034462E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29525
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: