Provider Demographics
NPI:1205853751
Name:DENTE, JOHN (MD, FACEP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DENTE
Suffix:
Gender:M
Credentials:MD, FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 TONBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-1219
Mailing Address - Country:US
Mailing Address - Phone:302-475-0434
Mailing Address - Fax:
Practice Address - Street 1:21 W CLARKE AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1840
Practice Address - Country:US
Practice Address - Phone:302-422-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0001785207P00000X
PAMD020780E207P00000X
MDD29910207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1205853751Medicaid
DE1205853751Medicaid
C48520Medicare UPIN