Healthcare Provider Details
I. General information
NPI: 1033734694
Provider Name (Legal Business Name): NEAL R KRENTZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/10/2020
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3126 N CIVIC CENTER PLZ
SCOTTSDALE AZ
85251-6912
US
IV. Provider business mailing address
4900 N 44TH ST APT 4055
PHOENIX AZ
85018-2882
US
V. Phone/Fax
- Phone: 480-874-2040
- Fax: 480-874-2041
- Phone: 248-410-4889
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 011660 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: