Active NPI
Dale Rennells
- Optician
- Phoenix, AZ
National Provider Identifier
1891581435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO002227
- Practice address
- 6150 S 35TH Ave
Phoenix, AZ 85041-5004 - Phone
- (602) 243-8523
- Fax
- (602) 243-8525
- NPI assigned
- Apr 18, 2025
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | LDO002227 | AZ | Primary |
Addresses
Primary practice location
6150 S 35TH Ave
Phoenix, AZ 85041-5004
Mailing address
6150 S 35TH Ave
Phoenix, AZ 85041-5004
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDO002227 | AZ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1891581435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6150 S 35TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850415004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6150 S 35TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850415004",
"telephone_number": "602-243-8523",
"fax_number": "602-243-8525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNELLS",
"first_name": "DALE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-18",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AZ",
"license": "LDO002227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.