Provider Demographics
NPI:1376954701
Name:KENLEIGH, DORIAN (MD, MPH, FACOEM)
Entity type:Individual
Prefix:DR
First Name:DORIAN
Middle Name:
Last Name:KENLEIGH
Suffix:
Gender:M
Credentials:MD, MPH, FACOEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 E CAMELBACK RD STE 1226
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4502
Mailing Address - Country:US
Mailing Address - Phone:602-989-2642
Mailing Address - Fax:623-401-7258
Practice Address - Street 1:3104 E CAMELBACK RD STE 1226
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4502
Practice Address - Country:US
Practice Address - Phone:602-989-2642
Practice Address - Fax:623-401-7258
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14130703-12052083X0100X, 2083T0002X
IN01076045A2083X0100X, 2083T0002X, 2083X0100X, 208D00000X
AZ589252083X0100X, 2083T0002X, 2083X0100X
CAC1672442083T0002X, 2083X0100X, 2083X0100X
WAMD611889012083X0100X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology