Provider Demographics
NPI:1114912441
Name:DENNISON, JANE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:M
Last Name:DENNISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3406
Mailing Address - Country:US
Mailing Address - Phone:401-247-1644
Mailing Address - Fax:401-247-4961
Practice Address - Street 1:234 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3406
Practice Address - Country:US
Practice Address - Phone:401-247-1644
Practice Address - Fax:401-247-4961
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI6326208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
404268OtherTUFTS
000627OtherBLUE CHIP
1200163OtherUNITED HEALTH CARE
22468OtherBLUE CROSS
RIJD00910Medicaid
RI6326OtherMEDICAL LIC
710048601OtherCIGNA
710048601OtherCIGNA
1200163OtherUNITED HEALTH CARE