Active NPI
David Lawrence Dennis, OD
- Optometrist
- Redding, CA
National Provider Identifier
1568499382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6199
- Practice address
- 3416 Bechelli Lane
Redding, CA 96002-2432 - Phone
- (530) 222-1422
- Fax
- (530) 222-5282
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6199 | CA | Primary |
Addresses
Primary practice location
3416 Bechelli Lane
Redding, CA 96002-2432
Mailing address
3416 Bechelli Lane
Redding, CA 96002-2432
Phone (530) 222-1422
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0061990 | Medicaid | CA | |
| 6199T | Other | CA | OPTOMETRIC LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6199 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207180800000",
"number": "1568499382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3416 BECHELLI LANE",
"city": "REDDING",
"state": "CA",
"postal_code": "960022432",
"telephone_number": "530-222-1422",
"fax_number": "530-222-5282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3416 BECHELLI LANE",
"city": "REDDING",
"state": "CA",
"postal_code": "960022432",
"telephone_number": "530-222-1422",
"fax_number": "530-222-5282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "DAVID",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2008-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "6199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0061990",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTOMETRIC LICENSE",
"identifier": "6199T",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.