Provider Demographics
NPI:1871672832
Name:HAMMOND, DENISE WEISHAUPT (DENTIST DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:WEISHAUPT
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:DENTIST DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E SINTON
Mailing Address - Street 2:
Mailing Address - City:SINTON
Mailing Address - State:TX
Mailing Address - Zip Code:78387
Mailing Address - Country:US
Mailing Address - Phone:361-364-4410
Mailing Address - Fax:361-364-3309
Practice Address - Street 1:620 E SINTON STREET
Practice Address - Street 2:
Practice Address - City:SINTON
Practice Address - State:TX
Practice Address - Zip Code:78387
Practice Address - Country:US
Practice Address - Phone:361-364-4410
Practice Address - Fax:361-364-3309
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX091115801Medicaid