Provider Demographics
NPI:1427014521
Name:DEMPSEY, JENNIFER O'BRIEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:O'BRIEN
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:748 QUINCY AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1739
Mailing Address - Country:US
Mailing Address - Phone:570-347-9600
Mailing Address - Fax:570-342-0681
Practice Address - Street 1:748 QUINCY AVE
Practice Address - Street 2:1A
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1739
Practice Address - Country:US
Practice Address - Phone:570-347-9600
Practice Address - Fax:570-342-0681
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005663213ES0103X, 213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016833350007Medicaid
PA1016933350003Medicaid
PA1016833350004Medicaid
PA1016833350006Medicaid
PA1016933350003Medicaid
PA1016833350007Medicaid
PA101450YGDBMedicare PIN