Individual provider Active NPI

Mark Steven Denunzio, D.D.S.

  • Endodontics
  • Pensacola, FL
National Provider Identifier
1356409262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN15284 Issued in FL
Practice address
6111 N Davis Hwy Ste B
Pensacola, FL 32504-6913
Phone
(850) 474-0565
Fax
(850) 474-0057
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN15284 FL Primary

Addresses

Primary practice location

6111 N Davis Hwy Ste B
Pensacola, FL 32504-6913

Mailing address

6111 N Davis Hwy Ste B
Pensacola, FL 32504-6913
Phone (850) 474-0565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN15284FLMDEndodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356409262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 N DAVIS HWY STE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046913",
            "telephone_number": "850-474-0565",
            "fax_number": "850-474-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 N DAVIS HWY STE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046913",
            "telephone_number": "850-474-0565",
            "fax_number": "850-474-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENUNZIO",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN15284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.