Provider Demographics
NPI:1437151073
Name:LEMON, DENNIS CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:CHARLES
Last Name:LEMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 TERMINAL WAY
Mailing Address - Street 2:STE A1
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3430
Mailing Address - Country:US
Mailing Address - Phone:775-331-6400
Mailing Address - Fax:775-331-3111
Practice Address - Street 1:1475 TERMINAL WAY
Practice Address - Street 2:STE A1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3430
Practice Address - Country:US
Practice Address - Phone:775-331-6400
Practice Address - Fax:775-331-3111
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV385207P00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002939Medicaid
NV01WCHDG17Medicare PIN
E07152Medicare UPIN
NVV01WCHDG17Medicare PIN