Healthcare Provider Details

I. General information

NPI: 1649614975
Provider Name (Legal Business Name): DENNIS ALEXANDER TENENBOYM D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 66TH ST N STE 207
PINELLAS PARK FL
33781
US

IV. Provider business mailing address

7800 66TH ST N STE 207
PINELLAS PARK FL
33781-2101
US

V. Phone/Fax

Practice location:
  • Phone: 727-399-7167
  • Fax: 727-440-8186
Mailing address:
  • Phone: 727-399-8186
  • Fax: 727-440-8186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3935
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3935
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: