Active NPI
Jerry L. Dennis, M.D.
- Psychiatry Physician
- Riverside, CA
National Provider Identifier
1841344348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C52116
- Practice address
- 4095 County Circle Dr
Riverside, CA 92503-3410 - Phone
- (951) 358-4621
- Fax
- (951) 358-4513
- NPI assigned
- Jan 22, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C52116 | CA | Primary |
Addresses
Primary practice location
4095 County Circle Dr
Riverside, CA 92503-3410
Mailing address
2252 Ravencrest CT
Riverside, CA 92506-4641
Phone (951) 683-5253
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52116 | CA | MD | Pharmacist |
| C52116 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252540800000",
"number": "1841344348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2252 RAVENCREST CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925064641",
"telephone_number": "951-683-5253",
"fax_number": "951-683-5238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4095 COUNTY CIRCLE DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033410",
"telephone_number": "951-358-4621",
"fax_number": "951-358-4513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "JERRY",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2009-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "C52116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.