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General NPI Number Information
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NPI Number | 1730660846
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Entity Type | Individual
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Provider Name | VINCENT MICHAEL DENINIS OD
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Gender | Male
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 10 WILLIAM POPE DR STE 6
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City | BLUFFTON
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State | SC
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Zip | 29909-7550
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Country | US
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Telephone | 843-705-1524
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Fax | 843-705-1524
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Provider Business Mailing Address
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Address Line | 11 PARKLANDS DR UNIT 638
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City | BLUFFTON
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State | SC
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Zip | 29910-5196
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Country | US
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Telephone | 607-727-0007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.2222
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 270A00726200
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License Number State | NJ
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