William J Dennis, D.C.
Individual provider Active NPI Chiropractor · Kuna, ID
NPI 1013086412 · NPPES record last updated Feb 19, 2013
Key facts
- NPI
- 1013086412
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIA-1067 (ID)
- Practice address
- 708 E Wythe Creek CT Ste 102a
Kuna, ID 83634-2473 - Phone
- (208) 922-9904
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1067 | ID | MD | Chiropractor |
| 4345 | AZ | MD | Pharmacy Technician |
| 1067 | ID | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-1067 | ID | Yes |
| Chiropractor | 111N00000X | 4345 | AZ |
Addresses
Primary practice location
708 E Wythe Creek CT Ste 102a
Kuna, ID 83634-2473
Mailing address
708 E Wythe Creek CT Ste 102a
Kuna, ID 83634-2473
Phone (208) 922-9904
Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.