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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
8664ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Talladega OB-GYN Associates, P C Obstetrics & Gynecology Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
17806MedicaidAL

Other providers in Talladega, AL

All providers in Talladega, AL · Obstetrics & Gynecology Physician in Alabama

Sources for this page

Verify at the official NPI Registry.