Provider Demographics
NPI:1518947803
Name:WENDERS, DENIS (OD)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:
Last Name:WENDERS
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 1:1 GRANITE POINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1992
Mailing Address - Country:US
Mailing Address - Phone:610-378-1344
Mailing Address - Fax:610-378-5169
Practice Address - Street 1:1494 ROUTE 61 HWY S STE 100
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-8404
Practice Address - Country:US
Practice Address - Phone:570-621-5690
Practice Address - Fax:570-622-9285
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000689152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007371640003Medicaid
PA410032468OtherRAILROAD MEDICARE
PA410032260OtherRAILROAD MEDICARE
PAU10072Medicare UPIN