Provider Demographics
NPI:1326068578
Name:YENN, DENNIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:YENN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 CARTWRIGHT AVE UNIT 304
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2359
Mailing Address - Country:US
Mailing Address - Phone:818-653-9366
Mailing Address - Fax:775-890-4170
Practice Address - Street 1:4400 CARTWRIGHT AVE UNIT 304
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2359
Practice Address - Country:US
Practice Address - Phone:818-653-9366
Practice Address - Fax:775-890-4170
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4165213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E41650Medicaid
CA000E41651Medicaid
CA000E41652Medicaid
CA000E41650Medicaid
CA000E41652Medicaid