George T Derenzo, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

G1-0001106 Issued in DE

Practice address

4201 Miller Rd
Wilmington, DE 19802-1914

Phone

(302) 354-6699

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gderenzo7543@direct.nemours.org

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.

• Dr. George T. Derenzo

  • Pediatric Dentistry
  • Wilmington, DE
  • NPI 1972720373
  NPD (past) Authorized official
• Brandywine Pediatric Dentistry, P.a.

  • Pediatric Dentistry
  • Wilmington, DE
  • NPI 1699235937
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1811047962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3079 SANTORINI CT",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341197708",
            "telephone_number": "302-354-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 MILLER RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198021914",
            "telephone_number": "302-354-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERENZO",
        "first_name": "GEORGE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "DE",
            "license": "G1-0001106",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DE",
            "license": "G1-0001106",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001060631",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Joseph W. Depenbusch, M.D.
• Steph Deputy
• Travis David Deputy, AU.D
• Christopher D. Derby, MD
• Dermatology Specialists of Delaware LLC
• Arthur Andrew Dermen, M.D.
• Kimberly M Ders, AGPCNP-BC
• Krupa Desai
• Meghana Desai, MEGHANA DESAI

• Orthodontics and Dentofacial Orthopedics Dentistry in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.