Provider Demographics
NPI:1982016747
Name:DEMPSEY, JUSTIN DEAN (DC)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:DEAN
Last Name:DEMPSEY
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 1:1413 VISCAYA PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-6206
Mailing Address - Country:US
Mailing Address - Phone:239-458-5747
Mailing Address - Fax:239-984-5365
Practice Address - Street 1:1413 VISCAYA PKWY
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-6206
Practice Address - Country:US
Practice Address - Phone:239-458-5747
Practice Address - Fax:239-984-5365
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12595OtherLICENSE