Provider Demographics
NPI:1679576177
Name:TENDLER, DRORY S (MD)
Entity Type:Individual
Prefix:DR
First Name:DRORY
Middle Name:S
Last Name:TENDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21001 N TATUM BLVD
Mailing Address - Street 2:SUITE 1630-480
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4206
Mailing Address - Country:US
Mailing Address - Phone:480-776-6844
Mailing Address - Fax:480-246-8940
Practice Address - Street 1:3100 W RAY RD STE 201
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2472
Practice Address - Country:US
Practice Address - Phone:480-776-6844
Practice Address - Fax:480-246-8940
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32962174400000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ867385Medicaid
AZAZ0760920OtherBCBS AZ
AZZ133519Medicare PIN
AZAZ0760920OtherBCBS AZ