Dennis Frank Dase, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Talladega, AL
NPI 1013984368 · NPPES record last updated Sep 14, 2012
Key facts
- NPI
- 1013984368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 8664 (AL)
- Practice address
- 724 Stone Ave
Talladega, AL 35160-2219 - Phone
- (256) 362-1410
- Fax
- (256) 362-0186
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8664 | AL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Talladega OB-GYN Associates, P C | Obstetrics & Gynecology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 8664 | AL | Yes |
Addresses
Primary practice location
724 Stone Ave
Talladega, AL 35160-2219
Mailing address
724 Stone Ave
Talladega, AL 35160-2219
Phone (256) 362-1410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17806 | Medicaid | AL |
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All providers in Talladega, AL · Obstetrics & Gynecology Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2012. 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.