MEDICARE: DR. DENNIS P PORTO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	27404	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689664112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS P PORTO MD

Provider Business Mailing Address
First Line	:	6000 UNIVERSITY AVE
Second Line	:	SUITE 230
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8203
Country	:	US
Telephone Number	:	515-222-0677
Fax Number	:	515-222-0019

Provider Business Practice Location Address
First Line	:	6000 UNIVERSITY AVE
Second Line	:	SUITE 230
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8203
Country	:	US
Telephone Number	:	515-222-0677
Fax Number	:	515-222-0019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. DENNIS P PORTO MD” Practice Location

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