Provider Demographics
NPI:1487651287
Name:HOSS, DENNIS CRAIG (OD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CRAIG
Last Name:HOSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3101
Mailing Address - Country:US
Mailing Address - Phone:785-841-5288
Mailing Address - Fax:785-749-2323
Practice Address - Street 1:3111 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3101
Practice Address - Country:US
Practice Address - Phone:785-841-5288
Practice Address - Fax:785-749-2323
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1195-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100219760AMedicaid
KS0776480001Medicare NSC
KST78503Medicare UPIN
KS005046Medicare PIN
KS100219760AMedicaid