Provider Demographics
NPI:1417732751
Name:ANTI, DENNIS JASON
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JASON
Last Name:ANTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 SOLDIERS HOME MIAMISBURG RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-1032
Mailing Address - Country:US
Mailing Address - Phone:916-346-5915
Mailing Address - Fax:509-651-9955
Practice Address - Street 1:3440 SOLDIERS HOME MIAMISBURG RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-1032
Practice Address - Country:US
Practice Address - Phone:916-346-5915
Practice Address - Fax:509-651-9955
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver