Healthcare Provider Details

I. General information

NPI: 1295802858
Provider Name (Legal Business Name): DENNIS TAITINGFONG BORJA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STERLING MEDICAL ASSOCIATES, 411 OAK STREET
CINCINNATI OH
45219
US

IV. Provider business mailing address

ATTN CREDENTIALS, 411 OAK STREET
CINCINNATI OH
45219
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 513-984-1800
  • Fax: 513-984-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberL764213
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: