Dennis Wentzel, RPH
Individual provider Active NPI Pharmacist · Earth City, MO
NPI 1851440804 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851440804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 040767 (MO)
- Practice address
- 13600 Shoreline Dr
Earth City, MO 63045-1220 - Phone
- (314) 493-7123
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040767 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 040767 | MO | Yes |
Addresses
Primary practice location
13600 Shoreline Dr
Earth City, MO 63045-1220
Mailing address
349 Imperial LN
Fenton, MO 63026-2818
Phone (314) 493-7123
Other providers in Earth City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.