=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477522373
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES ERIC DENNEMEYER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2006
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8573 E SAN ALBERTO STE E100
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-4612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-778-1732
-----------------------------------------------------
Fax | 480-778-1709
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 844 N THORNTON AVE
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-4003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-398-6470
-----------------------------------------------------
Fax | 407-894-6872
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | MD 034462E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 29525
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------