Healthcare Provider Details

I. General information

NPI: 1629702725
Provider Name (Legal Business Name): AMBER ANNETTE DENNIS CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 SAVAGE HILL RD
SUGAR GROVE OH
43155-9768
US

IV. Provider business mailing address

5030 SAVAGE HILL RD
SUGAR GROVE OH
43155-9768
US

V. Phone/Fax

Practice location:
  • Phone: 740-974-9377
  • Fax: 614-344-4445
Mailing address:
  • Phone: 740-974-9377
  • Fax: 614-344-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCPM24040435
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: