Provider Demographics
NPI:1922078294
Name:HARTMAN, DENNIS WHITTIER (OD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:WHITTIER
Last Name:HARTMAN
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 1:580 COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3121
Mailing Address - Country:US
Mailing Address - Phone:209-383-0989
Mailing Address - Fax:209-383-6836
Practice Address - Street 1:580 COLLINS DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3121
Practice Address - Country:US
Practice Address - Phone:209-383-0989
Practice Address - Fax:209-383-6836
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9253T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9253TOtherSTATE LICENSE
CASD0092530Medicare ID - Type Unspecified
CA9253TOtherSTATE LICENSE