Dennis Dejesus MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

26223 Issued in OK

Legal business name

DENNIS DEJESUS MD PA

Practice address

125 Beaver Dam Rd
Columbia, SC 29223-3101

Phone

(816) 536-2300

Fax

(866) 596-5119

NPI assigned

Jul 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Dejesus, M.D.

Title

President

Phone

(816) 536-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1407019706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 N CHATHAM AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512473",
            "telephone_number": "816-536-2300",
            "fax_number": "866-596-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BEAVER DAM RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292233101",
            "telephone_number": "816-536-2300",
            "fax_number": "866-596-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS DEJESUS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "DEJESUS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-536-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "26223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI DENNIS DEJESUS, MD",
            "identifier": "1629067327",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fang Emily Deng, M.D.,
• Erica Denham
• Jada Lashay Denis, RBT
• Dmitriy Vladimir Denissenko, DMD
• Leah Ruth Denman, LPC
• Laurel Ann Dennis, PA
• Tolvalyn Shinia Dennison, CNS
• Howard Stone Denny Jr., DMD
• Jennifer Michele Densmore
• Amanda Kathryn Denson

• Specialist in Columbia, SC
• Providers in Columbia, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.