Provider Demographics
NPI:1619060894
Name:DENITO, JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:DENITO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2500
Mailing Address - Country:US
Mailing Address - Phone:972-727-8947
Mailing Address - Fax:214-495-0891
Practice Address - Street 1:408 N ALLEN DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2500
Practice Address - Country:US
Practice Address - Phone:972-727-8947
Practice Address - Fax:214-495-0891
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
601150Medicare ID - Type Unspecified
T12988Medicare UPIN