Provider Demographics
NPI:1730153982
Name:DENNIS & DAVID COMPANY
Entity type:Organization
Organization Name:DENNIS & DAVID COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-628-5535
Mailing Address - Street 1:30150 TELEGRAPH RD STE 371
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5709
Mailing Address - Country:US
Mailing Address - Phone:888-628-5535
Mailing Address - Fax:888-892-3080
Practice Address - Street 1:30150 TELEGRAPH RD STE 371
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-5709
Practice Address - Country:US
Practice Address - Phone:888-628-5535
Practice Address - Fax:888-892-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F37594OtherBCBSM
MICH3719OtherMEDICARE RAILROAD
MIP110267OtherBLUE CARE NETWORK
MI3094815Medicaid
MIP110267OtherBLUE CARE NETWORK
MI3094815Medicaid
MI0M89690Medicare PIN
MI0M89690Medicare ID - Type Unspecified
MI0M88090Medicare ID - Type Unspecified