Provider Demographics
NPI:1245201599
Name:LENSER, DENA ANN (MD)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:ANN
Last Name:LENSER
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:PO BOX 578202
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-8202
Mailing Address - Country:US
Mailing Address - Phone:209-522-0001
Mailing Address - Fax:209-549-7077
Practice Address - Street 1:3109 COFFEE RD
Practice Address - Street 2:STE A
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-1766
Practice Address - Country:US
Practice Address - Phone:209-522-0001
Practice Address - Fax:209-549-7077
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83542208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G835420Medicaid